P032 Methotrexate and hepatic tolerance in Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
Y El Mabrouk ◽  
A Fazaa ◽  
L Souabni ◽  
M Sallemi ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Disease Onset ◽  
Prolonged Treatment ◽  
Hepatic Toxicity ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Pre Treatment ◽  
Seronegative Polyarthritis ◽  
Hepatic Cytolysis

Abstract Background Methotrexate (MTX) is considered as the main treatment for some juvenile idiopathic arthritis (JIA) subtypes. The hepatic toxicity of MTX has been reported in numerous studies in rheumatoid arthritis which have shown that prolonged treatment can induce hepatic fibrosis and a disturbance of the liver biologic tests. In patients with JIA, the potential hepatic toxicity of MTX needs to be confirmed. Methods A retrospective study of patients followed for JIA and treated with MTX was conducted. The results of the hepatic assessment looking for cytolysis or cholestasis performed during the pre-treatment assessment and then during regular checks were noted. Results Thirty-nine JIA patients were included. The mean age of disease onset was 8 years [1.5–17 years]. The JIA subtype was systemic in 11 cases, enthesitis related arthritis in 5 cases, rheumatoid factor seronegative polyarthritis in 15 cases and rheumatoid factor seropositive polyarthritis in 2 cases, and oligoarthritis in 2 cases. Patients were treated with low doses of corticosteroids (0.2–0.4 mg/kg) in majority of cases (82%). Non steroid anti-inflammatory drugs were used in 51% of cases. MTX was prescribed as monotherapy in 20 cases, in combination with Sulfasalazine in 6 cases and Anti TNF alpha in 12 cases. MTX has been used on average for 11 years [2 months-26 years]. This drug was stopped for ineffectiveness in 7 cases, for digestive intolerance in 2 cases and in one case for severe hepatic cytolysis after 2 years of treatment with a progressive normalization of hepatic laboratory tests after 6 months. During regular monitoring, no further disturbances of liver function were observed. Conclusion MTX hepatotoxicity appears to be very mild and rare in JIA. These results are reassuring given that MTX is a highly effective treatment in JIA.

scholarly journals AB0730 HIP INVOLVEMENT IN JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1395.3-1396
Author(s):  
S. Bouden ◽  
N. Ben Chekaya ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Hip Replacement ◽  
Joint Space Narrowing ◽  
Disease Onset ◽  
Joint Space ◽  
Hip Disease ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Inflammatory Syndrome

Background:Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases that have in common an onset before the age of 16 years, more than 6-month duration, and the presence of arthritis for at least 6 weeks with no identifiable cause. Hips are the commonly affected joints in severe destructive JIA. Hip disease develops in 20% to 50% of children with JIA.Objectives:We aimed to analyze the epidemiological, clinical, and radiological aspects of hip involvement in Tunisian JIA.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Clinical, biological and radiological parameters relating to the hip involvement were collected.Results:Thirty-five patients were enrolled. The mean age of the disease onset was 9 years [3-15]. The mean age of the patients at the time of the study was 37.8 years [17-69]. The mean duration of the disease was 27 years [2- 56]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (43.5%), rheumatoid factor negative polyarthritis (21.7%), enthesitis-related arthritis (17.4%), oligoarthritis (13%) and psoriatic arthritis (4.4%). A biological inflammatory syndrome was noted in 52% of patients. Hip involvement was noted in 43.5% of patients. Coxitis occurred on average 15 years after the JIA onset [[4-37]. Thirty four percent of the patients had bilateral hip involvement. The mean Lequesne index was 14. Joint space narrowing and erosions were noted in respectively 68% and 34% of cases. The majority of patients (82.6%) received medical treatment combining nonsteroidal anti-inflammatory drugs (NSAID) and rehabilitation. In the other cases, a total hip replacement was necessary. Coxitis was significantly correlated with rheumatoid factor positive polyarthritis subtype (p=0.02) and with the presence of biological inflammatory syndrome (p=0.03).Conclusion:Hip involvement is a major and highly prevalent issue in our JIA patients.Disclosure of Interests:None declared

Accuracy of Wallace Criteria for Clinical Remission in Juvenile Idiopathic Arthritis: a Cohort Study of 761 Consecutive Cases

2009 ◽  
Vol 36 (7) ◽  
pp. 1532-1535 ◽  
Author(s):  
ALFREDOMARIA LURATI ◽  
ALESSANDRA SALMASO ◽  
VALERIA GERLONI ◽  
MAURIZIO GATTINARA ◽  
FLAVIO FANTINI
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Laboratory ◽  
Survival Function ◽  
Disease Onset ◽  
Remission Status ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Laboratory Variables ◽  
The Mean ◽  
Seronegative Polyarthritis

Objective.To evaluate disease course and clinical usefulness in some categories of juvenile idiopathic arthritis (JIA) by applying newly developed Wallace definitions of remission off drugs.Methods.In a retrospective study, charts of patients with chronic form of primary (idiopathic) arthritis followed from our center since 1970 were reviewed and clinical/laboratory variables were collected for further analysis.Results.The cohort included 761 eligible patients [516 (67.8%) female, 245 (32.2%) male] with JIA. Mean disease onset age (± standard deviation) was 6.25 ± 4.4 years (range 0.5–15.9). Disease mean duration to last visit was 10.02 ± 4.31 years. Followup mean period was 7.6 ± 6.4 years (range 1.5–35 yrs). A total of 247 (32.46%) patients achieved remission according to criteria [persistent oligoarthritis 153 (42.9%); extended oligoarthritis 15 (13.1%); seronegative polyarthritis 21 (22.4%); systemic arthritis 33 (33.7%); enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 25 (33.4%)]. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (± standard error of the mean) before relapse calculated by Kaplan-Meier was of 20.9 (± 1.3) months overall: 21.7 (± 0.46) in persistent oligoarthritis, 25.0 (± 6.6) in extended oligoarthritis, 26.7 (± 13.2) in seronegative polyarthritis, and 17.6 (± 2.44) in ERA+JPsA (p > 0.1).Conclusion.In our cohort about one-third of cases obtained a remission episode in 4 decades of observation, with a significant difference between oligoarthritis and other categories (p < 0.001) using the Kaplan-Meier method; the remission status duration before a relapse has been about 20 months, without a significant difference between JIA categories.

scholarly journals AB0732 JUVENILE IDIOPATHIC ARTHRITIS IN ADULTHOOD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1396.2-1396
Author(s):  
N. Ben Chekaya ◽  
S. Bouden ◽  
A. Ben Tekaya ◽  
O. Ben Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Joint Destruction ◽  
Disease Onset ◽  
Failure To Thrive ◽  
Overweight And Obesity ◽  
Physical Growth ◽  
The Mean ◽  
Active Disease

Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unknown aetiology in childhood. Approximately 40- 60% of patients with juvenile idiopathic arthritis (JIA) have continuous or recurrent disease activity extending into adulthood.Objectives:The aim of this study was to evaluate the clinical, biological and radiological course of JIA in adulthood.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Patients with JIA older than 20 years were included. Data regarding sociodemographic features, Physical growth, disease activity, biological and radiological parameters were analysed.Results:Thirty one patients were recruited. The sex ratio was 0.53. The mean age at the time of the study was 38.9 years [20-69]. The mean age of the disease onset was 9 years [3-16]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (47.7%), rheumatoid factor negative polyarthritis (23.9%), oligoarthritis (14.2%), enthesitis-related arthritis (9.5%), and psoriatic arthritis (4.7%).A failure to thrive was seen in 33.3% of patients. Overweight and obesity were found in 38% and 19% of patients, respectively. Biological inflammatory syndrome was noted in 52% of patients, and 65.2% had active disease. Hip involvement was noted in 43.5% of patients and 17.4% of them had a total hip replacement. Sixteen patients had neck pain and the imagining showed an atloid-axoid dislocation in 50% of them. Radiographs showed a joint destruction in 60.9% of patients and a wrist arthritis was the most frequent involvement.Conclusion:Most of our included patients maintain active disease and have functional impairment in adulthood.Disclosure of Interests:None declared

P031 Adherence with Methotrexate in Tunisian Juvenile Idiopathic Arthritis Patients

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hiba Bettaieb ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Hanene Ferjani ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Pediatric Population ◽  
Demographic Data ◽  
Disease Onset ◽  
Weekly Dose ◽  
Cross Sectional ◽  
High Adherence ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in the pediatric population. Methotrexate (MTX) has been considered as the cornerstone of treatment of poly and oligoarticular subtypes of JIA. However, this treatment is supposed to be for long term, which may involve an obstacle for adherence. The aims of the study were to evaluate adherence of Tunisian JIA patients to MTX and to identify factors associated with high adherence to MTX. Methods A cross-sectional study including patients with confirmed JIA diagnosis, according to the International League of Associations for Rheumatology (ILAR) criteria, was performed. Demographic data as well as disease characteristics were obtained from medical records. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Adherence was measured, for patients under MTX for &gt;3 months, using the 5-item Compliance Questionnaire Rheumatology (CQR5) (1). Patients were divided into two groups: group 1: High adherence (HA) for patients having a CQR5 ≥ 80% and group 2: low adherence (LA) for patients having CQR5 &lt; 80%. A p inferior to 0.05 was considered statistically significant. Results The study included 29 patients (10 males and 19 females) with a mean age at disease onset of 9.1 ± 3.4 years. The mean disease duration was 61 ± 79 months [7–336]. JIA subtypes were in decreasing order of frequency as follows: enthesitis-related arthritis (n = 13), oligoarticular (n = 8), Polyarticular without rheumatoid factor (n = 4), Polyarticular with rheumatoid factor (n = 2), systemic (n = 1) and, psoriatic arthritis (n = 1). A biologic inflammatory syndrome was found in 48.3% (n = 14) of cases. The mean ESR and CRP were 20 mm/h ± 11.3 [3–98] and 5 ± 17.8 mg/l [0–56] respectively. Nineteen (65.5%) patients had coxitis. Overall, 55.17% of patients (n = 16) were treated with MTX with a mean weekly dose of 9.2 ± 3.2 mg [5–15]. MTX was orally administrated in all patients. NSAIDs and prednisone were prescribed in 51.7% (n = 15) and 17.2% (n = 5) of cases respectively. The MTX was associated with biological DMARDs in five patients (17.2%). It was about Etanercept in 4 patients and Tocilizumab in 1 patient. Mean CQR5 score was 70.8% ± 18 [25–100]. Only seven patients (43.8%) showed high adherence to MTX. The statistical study revealed no difference between HA and LA in term of gender (P = 0.84), age at disease onset (P = 0.39), disease duration (P = 0.9), prednisone use (P = 0.22), the occurrence of coxitis (P = 0.2), ESR (P = 0.83) and CRP (P = 0.033) rates. Conclusion In this study, less than one half of JIA patients were highly adherent to MTX according to CQR5. Low adherence should be considered before declaring MTX treatment failure.

scholarly journals AB0731 CERVICAL SPINE INVOLVEMENT IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1396.1-1396
Author(s):  
S. Bouden ◽  
N. Ben Chekaya ◽  
A. Ben Tekaya ◽  
O. Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cervical Spine ◽  
Rheumatoid Factor ◽  
Disease Onset ◽  
Odontoid Process ◽  
Basilar Invagination ◽  
X Rays ◽  
Radiological Data ◽  
Adult Rheumatoid Arthritis ◽  
The Mean

Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. In contrast to adult rheumatoid arthritis, where numerous studies have shown a high prevalence of involvement of the cervical spine, few studies have been published examining this entity in JIA.Objectives:We aimed to analyze clinical and radiological findings of cervical spine involvement in patients with JIA.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Clinical, biological, and radiological data were collected. Patients had a radiological evaluation that included cervical spine x-rays in antero-posterior, lateral and lateral views with flexion.Results:Thirty-five patients were enrolled. The mean age of the disease onset was 9 years [3-15]. The mean age of the patients at the time of the study was 37.8 years [17-69]. The mean duration of the disease was 27 years [2-56]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (43.5%), rheumatoid factor negative polyarthritis (21.7%), enthesitis-related arthritis (17.4%), oligoarthritis (13%) and psoriatic arthritis (4.4%). Sixteen patients (45%) reported neck pain. Cervical spine involvement occurred on average 7 years [0-13] after the JIA onset. Cervical spine radiographs showed anterior atlantoaxial subluxation (> 5mm) in 8 patients. Magnetic-resonance imagining was performed in 9 patients that had abnormal neurological examination showing a pannus formation of C1-C2 junction (3 cases), a basilar invagination (4 cases) and erosions of the odontoid process (2 cases). A cervical collar has been used for immobilization in patients with significant cervical spine damage. A C1-C2 arthrodesis was proposed to 4 patients.Conclusion:These findings suggest that the presence of cervical involvement in JIA patients is frequent. Radiologic assessment of cervical spine should be systematically performed for early detection and to prevent its complications.Disclosure of Interests:None declared

P019 Adulthood of juvenile idiopathic arthritis patients: professional outcome

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
College Graduates ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
Full Time ◽  
Family Status ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
The Mean ◽  
Professional Outcome

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of rheumatic diseases characterized by onset before the age of 16. Since the disease starts at an early age, it may lead to socio-professional difficulties in adulthood for JIA patients. This study aimed to describe the professional outcome of a series of 20 JIA patients. Methods A cross-sectional study including patients aged 20 years and more and fulfilling the ILAR criteria for the diagnosis of JIA was carried out. Telephone interviews were conducted. The responders answered questions about family status, current occupation, working h, eventual workplace adjustments, and sick leave frequency. Results Twenty patients answered the questionary; 14 males and 6 females. The mean age of the disease onset was 8 years. The mean age of patients at the time of the study was 24.27 years [20–36]. Polyarticular form was the most frequent (10 cases). Other subtypes diagnosed were systemic (4 cases), enthesitis-related arthritis (5 cases), oligoarticular (one case). Hip arthritis was observed in 8 patients and surgical intervention was needed in three. Eight patients were treated with csDMARDSs and 12 with bDMARDs. Three of our patients were married (aged 24, 34, and 36). Five were still studying: 4 had good grades without absenteeism. However, one patient needed special aid to go to school and had a higher absence rate. Five other patients were full-time college students without absenteeism. Four patients were college graduates. Among them, two were searching for a job for &gt;6 months. The other two were full-time administrative workers with no absenteeism. One patient did need workplace adjustments. Six patients could not work because of their physical disabilities. Conclusion According to our results, a quarter of our patients could not access professional life. Disease activity and hip destruction are the two main factors causing JIA patients to miss out on important personal and professional opportunities.

Predictors of Hip Disease in the Systemic Arthritis Subtype of Juvenile Idiopathic Arthritis

2011 ◽  
Vol 38 (5) ◽  
pp. 954-958 ◽  
Author(s):  
MICHELLE BATTHISH ◽  
BRIAN M. FELDMAN ◽  
PAUL S. BABYN ◽  
PASCAL N. TYRRELL ◽  
RAYFEL SCHNEIDER
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Median Time ◽  
Joint Destruction ◽  
Disease Onset ◽  
Systemic Jia ◽  
Kaplan Meier ◽  
Hip Disease ◽  
The Mean ◽  
Censored Observations ◽  
Aggressive Interventions

Objective.Hip involvement occurs in 20%–40% of all cases of juvenile idiopathic arthritis (JIA). Patients with systemic JIA (sJIA) are affected most frequently. The aim of our study was to investigate the predictors of clinical hip disease and radiographic hip damage in sJIA.Methods.The medical records (1997–2007) of all children (n = 98) with sJIA were reviewed. Potential clinical and laboratory predictors were examined at presentation and at 3 and 6 months. To account for censored observations, we used survival analysis.Results.During the study period, 59 children met our inclusion criteria. The mean age at diagnosis was 7.8 years. Thirty patients (51%) developed clinical hip disease, with 12 (20%) developing radiographic evidence of hip damage. The median time to develop clinical hip disease was 24 months. Using Kaplan-Meier estimates, 25% of patients develop radiographically evident hip damage within 43 months. At presentation, patients in whom clinical hip disease later developed had polyarthritis (hazard ratio 2.51, p = 0.01), elevated IgG (HR 1.12, p = 0.01) and IgM (HR 2.71, p = 0.02), and higher CHAQ scores (HR 1.65, p = 0.02). At 3 months after disease onset, patients in whom radiographic hip damage later developed had fever (HR 4.78, p = 0.02), polyarthritis (HR 4.63, p = 0.02), and higher CHAQ scores (HR 3.20, p = 0.005). At 6 months, polyarthritis was the strongest predictor of both clinical hip disease and radiographic hip damage.Conclusion.Half of patients with sJIA develop clinical hip disease a median time of 24 months from diagnosis. Early identification of predictors of hip disease and damage in patients with sJIA may suggest earlier, more aggressive interventions to prevent joint destruction.

P035 Hip involvement in Tunisian Juvenile Idiopathic Arthritis patients

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Makhlouf Yasmine ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Hanene Ferjani ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Age At Onset ◽  
Joint Damage ◽  
Joint Effusion ◽  
Male Predominance ◽  
Disease Characteristics ◽  
Tunisian Patients ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Abstract Background Juvenile idiopathic arthritis (JIA) is characterized by a widely variable clinical course and outcome. If uncontrolled, joint damage may occur. In this context, coxitis is a feared complication. The aim of our study was to determine the prevalence and patterns of hip involvement in Tunisian JIA patients. Methods A retrospective study including children with JIA according to the International League of Associations for Rheumatology (ILAR)) was conducted between 2012and 2021. Sociodemographic data as well as disease characteristics were collected. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded. Hip involvement was assessed clinical exam and imaging (standard radiograph, ultrasound or magnetic resonance imaging (MRI)). We compared these parameters between the two groups: G1: presence of coxitis and G2: absence of coxitis. Results The study included 40 patients with a male predominance: sex ratio was 1.6. The mean age was 11.1 years-old [3–16]. The mean age at onset of the disease was 18.1 years old [8–30]. The distribution of the different subsets was as follows: polyarticular with rheumatoid factor (n = 1), polyarticular without rheumatoid factor (n = 2), enthesitis-related arthritis (n = 29), oligoarthritis (n = 7), psoriatic arthritis (n = 1). Extra-articular manifestations were found in 21.2% of cases: ocular (n = 4), pulmonary (n = 2) and cardiovascular (n = 1). The mean ESR and CRP was 30.9 mm/h [2–90] and 15.8 mg/l [1–70] respectively. A high ESR or CRP were found in 67% of cases. Hip involvement concerned 70% of the patients and was bilateral in 67.9% of them. Hip radiographs were normal in 50% of cases. Ultrasound was performed in 9 patients and revealed a positive Doppler synovitis (n = 2), a negative Doppler synovitis (n = 7) and joint effusion (n = 2). MRI was performed in 20% of cases and revealed synovitis (67%) and joint effusion (33%). Overall, 79.3% of patients had medical treatment combining NSAIDs and rehabilitation, 39% of the patients had had local infiltration with Hexatrione and only two patients had hip replacement. Hip involvement was not correlated with age at onset (P = 0.2), subtype (P = 0.8), sex (P = 0.7), extraarticular manifestations (P = 0.4). Similarly, there was no correlation between the presence of coxitis and ESR (P = 0.07) as well as CRP (P = 0.5). Conclusion Our study showed that hip involvement is frequent among Tunisian patients with JIA. Although not correlated with disease characteristics, hip involvement should be assessed frequently and carefully.

P036 Juvenile Idiopathic Arthritis in adulthood: outcomes of oligo and polyarticular forms?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Miladi Saoussen ◽  
Makhlouf Yasmine ◽  
Fazaa Alia ◽  
Sellami Mariem ◽  
Ouenniche Kmar ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Transition To Adulthood ◽  
Disease Onset ◽  
Adult Life ◽  
Treatment Modalities ◽  
Disease Characteristics ◽  
Female Predominance ◽  
Tunnel Syndrome ◽  
The Mean ◽  
International League

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease of childhood that can cause major physical disability, impairing patients' ability to lead a normal adult life. The objective of this study was to assess the outcomes of oligo- and polyarticular JIA in adulthood as well as the progression to authentic rheumatoid arthritis (RA). Methods We conducted a retrospective study including adult patients with JIA (diagnosed according to the International League of Associations for Rheumatology [ILAR]). Data collected included age, gender, disease characteristics (JIA subtype, disease duration). The progression to an authentic RA was determined by checking the response to the ACR/EULAR 2010 classification criteria. Results Twenty-eight patients were included in this study. There was a female predominance with a sex ratio of 1.5. The mean age of disease onset was 6 years and 2 months [2–17]. The mean age at inclusion was 29.5 years [18–64]. The frequency of each JIA subtype was as follows: polyarticular with RF + (n = 14), polyarticular with RF- (n = 9), oligoarthritis (n = 5). The polyarticular forms: RF+ and RF- evolved into genuine seropositive and seronegative RA in 71.4% and 66.7% of cases, respectively. Among the oligoarticular JIA subtype, an extension of the disease to a seronegative RA was noted in one patient (20%). Hip involvement was noted in 20% of patients. Carpal tunnel syndrome and elbow arthritis were found in 28.5% and 14.3% of patients, respectively. Regarding treatment modalities and at the time of recruitment, 36.3% of RAs were treated with Methotrexate, and 33% were on biological treatment. Ten percent of the patients dropped out of school because of disease flares and deformities. Conclusion Our study showed oligo- and polyarticular JIA evolves in most of the cases towards an authentic RA causing deformities and handicaps. Earlier management is necessary to allow a better transition to adulthood.

scholarly journals AB0744 HOW JUVENILE IDIOPATHIC ARTHRITIS PATIENTS PERCEIVE THEIR ILLNESS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1400.3-1401
Author(s):  
K. Maatallah ◽  
M. Yasmine ◽  
H. Ferjani ◽  
W. Triki ◽  
D. Ben Ncib ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Emotional Response ◽  
Illness Perceptions ◽  
Illness Perception ◽  
Personal Control ◽  
Treatment Control ◽  
Control Item ◽  
The Mean ◽  
Child Age

Background:Juvenile idiopathic arthritis (JIA) represents the most common inflammatory rheumatism of childhood. Because of a prolonged course of active disease, many patients experience physical and psychosocial limitations. Illness perceptions involve the personal beliefs that patients have about their illness and may influence health behaviors considerably.Objectives:The present study aimed to investigate the illness perception of patients with JIA.Methods:We conducted a cross-sectional study including children with JIA (according to the International League of Associations for Rheumatology (ILAR)). We recorded sociodemographic data and the subtype of the JIA. To assess a child’s perception of how arthritis affects their life, the Brief Illness Perception Questionnaire (IPQ) was completed by the parent (child age ≤10 years) or by the child (age ≥11 years). The Brief IPQ is a nine-item questionnaire rated using a 0-to10 response scale that assesses cognitive illness representations: consequences (Item 1), timeline (Item 2), personal control (Item 3), treatment control (Item 4), and identity (Item 5). Two of the items assess emotional representations: concern (Item 6) and emotions (Item 8). One item assesses illness comprehensibility (Item 7).Results:The study included 22 patients. The mean age was 15 ± 7 years [4-35], and the mean age at diagnosis was 9 ±3 years [3-14]. There was a female predominance (sex ratio= 2.1). The frequency of each JIA subset was at follows: polyarticular with rheumatoid factor (n= 1), polyarticular without rheumatoid factor (n=3), systemic (n= 2), enthesitis-related arthritis (n=9), oligoarthritis (n= 7), undifferentiated (n=1). Non-steroidal anti-inflammatory drugs were prescribed in 72% of cases, and Cs-DMARDs in 59% of patients. The most-reported causal factor in their illness was a history of traumatism (22%). Perceiving symptoms (identity) were significantly related to being affected by the disease (emotional response) (p= 0.01). Conversely, patients who had personal and treatment control expressed less emotional response (r = −0.7, r=-0.2 respectively). Moreover, those who were concerned about the disease perceived more the consequences of their illness (p=0.09) and understood it more (p=0.029). We also noted significant correlations between personal control and treatment control (p = 0.033). A positive correlation was found between identity as well as consequences and timeline (p=0.011, p=0.024), showing that the perception of chronicity was associated with pain and the burden of the disease.Conclusion:Our study highlighted the importance of assessing illness perception in JIA patients. Patient education programs should be implemented since diagnosis for better disease management.Disclosure of Interests:None declared

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