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OP0136 Abatacept Treatment during 1 Year Period in Juvenile Idiopathic Arthritis Associated Uveitis without Previous Biologics Therapy
  1. L. Galstian,
  2. E. Zholobova,
  3. O. Loskutova,
  4. M. Nikolaeva
  1. I.M. mSECHENOV First Moscow State Medical University, Moscow, Russian Federation

Abstract

Background Biological DMARDs have an important role in the treatment of juvenile idiopathic arthritis (JIA) associated uveitis refractory to previous standard treatment.

Objectives The aim of this prospective study was assessment of Abatacept (ABA) efficacy in JIA associated uveitis.

Methods Among 17 patients with JIA and eye involvement included in the study, 9 children had oligo-articular JIA, 7 children – polyarticular, 1 patient had systemic disease. Study group included 13 girls and 4 boys. Mean age was 7,10 ± 2,16 years, age of disease onset was 3,70±3,05years; mean disease duration before ABA administration was 6,40±3,21. Disease onset with initial joint damage was observed in 10 children, with eye involvement- in 7 children.

Prior to ABA administration all children received immunosuppressive drugs: 12 children (70,58%) methotrexate (MTX) 10–15mg/m2 of body surface per week, 2 children (11,8%) received Sandimunne Neoral as monotherapy and with methotrexate combination – 3 patients (17,6%), 2 children received oral corticosteroids (CS), 17 children (100%) received topical treatment of uveitis.

Number of active joints was 8,7±2,6, mean ESR was 20, 0±10,32mm/h, CRP 1,18±1,05mg/dl (ref. <0,8mg/dl). RF positive was detected in 2 children, negative - in 15 children, ANA positive in 14 children (82,35%) with 1:160- 1:180 rate.

VAS physician was 73, 4±15, 0, VAS patient/parent was 68, 7±16, 2. Mean functional disability in patients before ABA administration was 1, 03 ±0, 48.

All 17 patients had active uveitis at the moment of ABA administration. 9 (53%) patients had bilateral ocular involvement, 8 patients (47%) - unilateral.

Results After 6 months of ABA therapy mean ESR decreased from 20, 0±12, 32 mm/h to 17.2±4,28mm/h, CRP – from 1, 18±1, 05 mg/dl to 1,05±0,75mg/dl. ACRpedi-30 was achieved in 10 from 17 (58,82) % patients, ACRpedi-50- in 4 patients (23,52%), ACRpedi -70- in 3 children (17,64%). Uveitis remission was achieved in 22% eyes; 46% showed a significant reduction in inflammatory activity, 32% had no significant dynamic.

After 12 months of ABA therapy number of active joints decreased from 8, 7±2, 6 to 5, 63± 1, 4. Mean ESR decreased from 20, 0±12, 32 mm/h to 10,0±4,6mm/h, CRP –0±0,31mg/dl, VAS physician decreased from 73, 4±15,0 to 42,4±13,5, VAS patient/parent decreased from 68, 7±16, 2 to 50,0 ± 14,0. ACRpedi-50 was achieved in 13 patients (76,4%), ACRpedi-80 - in 2 children (11,76%). Regarding uveitis 21% eyes had uveitis remission; 36% – sub active process. Flares were observed in 43% eyes.

Conclusions Abatacept treatment during 12 months period was effective in JIA associated uveitis with 82% ANA positivity without previous biologics therapy.

Disclosure of Interest None declared

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