Background Follow-up care and social adaptation issues in adult patients with childhood onset arthritis are highly relevant, as the prognosis and long-term outcomes of the disease are not sufficiently studied.
Objectives To assess long-term outcomes and social status of adults with childhood onset arthritis.
Methods Establishment of the adult patients with childhood onset arthritis database, covering the period from 2003 year to 2015 year, allowed to analyze the disease activity, the radiographic stage and functional class (using Steinbrocker method), complications, used pharmacotherapies, as well as social status (education, professional activity, marital status).
Results The database includes 235 patients: 176 females, 59 males, mean age 27.7±8.0 years, disease duration 18.1±8.5 years. Persisting arthritis was found in 72% patients. Radiographic stage II was established in 139 patients, stage III – in 49, stage IV – in 47 patients. Functional class II predominates in the majority of patients. The most common disease-modifying anti-rheumatic drug (DMARD) used was methotrexate – in 73% of patients, each 3rd patient was taking sulfasalazine, each 4th - leflunomide, 15% of patients had never used whatever DMARDs. 53 patients were administered biologic drugs: 30 patients received 1, 16 patients – 2, 6 patients – 3, 1 patient received 4 of biologic drugs. Glucocorticoids (GCs) were administered in 55% of patients, more than 60% continue on GCs, including 42 patients using GCs for >10 years. Aseptic bone necrosis (predominantly of femoral head) was reported in 25% of patients. Bone fractures were documented in 8 patients. Joint prosthetics were required in 23 patients: single joint – in 9, 2 joints – in 11, 3 joints – in 2, 4 joints - in one patient. Arterial hypertension, requiring medication, was found in 12 patients. Nanism was diagnosed in 27 patients, primary amenorrhea – in 11, secondary amenorrhea – in 2, steroid diabetes – in 2 patients. Light perception visual acuity was documented in 2 patients, poor vision was reported in 3 patients. Amyloidosis was found in 2 cases. At present higher education was finished or in the process of continuation by 49 patients (including 2 patients – in medical institute), special education was finished or in the process of continuation by 169 patients. Only school education has 17 patients. Out of those with full education (127 patients) 85 are working (including 2 rheumatologists and 1 pediatrician), while 42 patients are in dependence. 52 patients have family (93% - women), 36 patients (91% - women) have children: one – 27, two – 7, three – 1, six – 1.
Conclusions Only 1/3 of adult patients with childhood onset arthritis have satisfactory long-term clinical outcomes; at the same time the majority of patients are well adapted socially.
Disclosure of Interest None declared