Background Despite active therapy in adult patients with childhood onset arthritis, the aim of therapy is not always achieved, which explains non satisfactory outcomes.
Objectives To analysis of database of adults with childhood onset arthritis.
Methods Analysis of database for the 9-years period of observation (2003-2011 years).
Results Database contains information about 190 adult patients with the age of disease onset was 8.3±4.7 years: 142 women, 48 men in the age from 17 to 64 (mean 24.9±8.1) years, disease duration from 1 to 50 (mean 16.7±8.3) years. Disease activity (according to DAS28) was found in 88.9% of patients (I – in 122, II – in 38, III – in 9), non-medicamental remission - in 21 patients. I radiological stage was stated in 4, II – in 100, III – in 47, IV – in 39 patients. The majority of patients (91.6%) had the II functional class, 4 patients move in wheel-chair. Disease-modifying anti-rheumatic drugs (DMARDs) receive 83% patients: methotrexate – 83 (the duration use of 9.0±4.1 years, 30 patients take it for more than 10 years), leflunomide – 35, other DMARDs (sulphasalazine, hydroxychloroquine, cyclosporine, azathioprine) – 40 patients. Never took DMARDs 32 patients. 20 patients receive biological agents. Glucocorticoids (GC) were prescribed to 106 patients, 64% patients continue taking them, 39 patients - for more than 10 years. Aseptic bone necrosis was diagnosed in 43 patients, the majority of patients (83.7%) had used GC; while 70 patients who took GC did not develop aseptic bone necrosis. 54 patients on GC-therapy demonstrated osteoporosis, while 4 patients with osteopenia never had receive GC. Bone fractures were diagnosed in 7 patients on GC-therapy: hip – in 4, forearm – in 2, metatarsal bones – in 1. Nanism was found in 26, primary amenorrhea – in 11, secondary amenorrhea – in 2 patients. Steroid cataract was found in 7 patients, steroid diabetes – in 1 patient.
Conclusions The activity of the disease and serious complications is observed in the majority of adults with childhood onset arthritis, which necessitates further studies, aimed at therapy optimization.
Disclosure of Interest None Declared
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