BackgroundThe Juvenile Arthritis Disease Activity Score (JADAS) is a feasible tool which consists of four items: tender (TJC) or swollen joint count (SJC), the physician and the patient’s/parent’s global assessment and the erythrocyte sedimentation rate (ESR). C-reactive protein (CRP) has also been suggested as an alternative inflammatory marker.ObjectivesTo compare the performance of JADAS-ESR and JADAS-CRP in the evaluation of JIA activity.MethodsTwenty nine patients who met the International League of Associations for Rheumatology (ILAR) criteria for JIA were enrolled in the study. Disease activity was assessed by the JADAS-ESR and JADAS-CRP scores at 54 consultations, 29 at baseline and 25 during the last follow-up consultation. Data of JIA subtypes, disease duration and treatment were retrospectively collected from medical records. All data were checked for normality by the Kolmogorov-Smirnov test. The Spearman correlation was used for data analysis and p values less than 0.05 were considered statistically significant.ResultsThe mean age of our population was 13.1±4.2 years [4-21] and the sex ratio of males to females was 1.07. The mean disease duration was 4.69±3.26 years [0.3-13]. JIA subtypes were: enthesis-related arthritis (n=12), polyarthritis (n=7), oligoarthritis (n=6), undifferentiated (n=3) and psoriatic arthritis (n=1). At baseline most of our patients (51,73%) were not under treatment, 34.49% were under non-steroidal anti-inflammatory drugs (NSAIDs) and 13.8% under methotrexate (MTX). At the last follow-up consultation 41.38% of the patients were under MTX, 34.49% under NSAIDS and 10.35% under TNF inhibitor (Etanercept). At baseline JADAS-ESR1 was correlated to JADAS-CRP1 (p<0.001, r=0.808) in all AIJ subtypes. JADAS-ESR1 and JADAS-CRP1 were not correlated to ESR1 (p=0.416, p=0.661) nor to CRP1 (p=0.376, p=0.058). Both JADAS-ESR1 and JADAS-CRP1 were correlated to TJC1 (p<0.0001, r=0.643; p=0.015, r=0.502) and only JADAS-ESR1 was correlated to SJC1 (p=0.012, r=0.461). At the last follow-up consultation, correlations were observed between JADAS-ESR2 and JADAS-CRP2 (p<0.001, r=0.992) in all AIJ subtypes. JADAS-ESR2 and JADAS-CRP2 were both correlated to CRP2 (p=0.015, p=0.003) but not to SJC (p=0.175, p=.119), nor to ESR2 (p=0.535, p=0.426).ConclusionOur study suggests that both JADAS-ESR and JADAS-CRP correlate closely during the follow-up of JIA. JADAS-CRP could be recommended for assessing disease activity in JIA.Disclosure of InterestsNone declared

BackgroundReligious events are privileged occasions for sharing and conviviality. In a joyful atmosphere, festive meals are shared with family, neighbors, and friends, and gifts are exchanged. Little is known about the impact of chronic inflammatory rheumatic diseases on patients’ celebrations of religious events.ObjectivesTo study the satisfaction of patients with their religious rituals during Islamic holidays.MethodsWe conducted a transversal study, including patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). Patients were invited to answer to a satisfaction scale (SS) composed of four domains: prayer practice, religious food preparation, family visits, and satisfaction with spiritual fulfillment. For each domain, there were 6 degrees of satisfaction (extremely satisfied, satisfied, slightly satisfied, slightly dissatisfied, dissatisfied, extremely dissatisfied) rated from 1 to 6 from best to worst satisfaction. The sub-SS for each domain ranged from 1 to 6, and the global SS ranged from 4 to 24.ResultsSeventy-one patients (45 females) answered the SS with a median age of 48±13 [20-81] years. Thirty-three patients had RA and thirty-eight SpA with a mean disease duration of 8±7.3 [0.04-36] years. The RA and SpA were active according to DAS28 and BASDAI in, respectively, 78% and 47% of cases. The mean global SS was 13.2±3.1 [6-23] and the mean sub-SS for prayer practice was 3.3±1.3 [1-6], for religious food preparation was 4±1.4 [1-6], for family visits was 3±1.3 [2-6] and for satisfaction for spiritual fulfillment was 3.3±1.4 [1-6].A better satisfaction with prayer practice and religious food preparation was correlated with age (p=0.04, p=0.043, respectively) and married marital status (p=0.021, p=0.008, respectively). SpA patients reported less satisfaction with prayer practice than RA patients (sub-SS means 3.44 versus 3.13), but this did not reach a statistically significant level (p=0.337). Patients with inactive disease reported better satisfaction with family visits than those with active disease (sub-SS means 2.46 versus 3.04) but without statistically significant difference (p=0.178). The satisfaction with spiritual fulfillment correlated with age (p=0.001), whereas there were no associations with gender (p=0.216), type of the rheumatism (p=0.653) and disease activity (0.516). There was no correlation between the global SS and the type of rheumatism, disease activity, and gender (p=0.631, p=0.403, p=0.569, respectively).ConclusionOur study showed that RA and SpA affect negatively patients’ religious practices, especially prayer practice, religious food preparation, and spiritual fulfillment. Therefore, the impact on religious rituals should be taken into account when assessing the quality of life of patients with rheumatic diseases.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundThe neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have recently emerged as potential indicators of systemic inflammation in chronic rheumatic diseases such as polymyalgia rheumatica, rheumatoid arthritis, and spondyloarthritis.ObjectivesTo investigate the value of NLR and PLR as inflammatory markers in juvenile idiopathic arthritis (JIA) and to explore possible associations with disease activity parameters.MethodsWe enrolled 29 patients with JIA according to International League of Associations for Rheumatology (ILAR) criteria. Tender joint count (TJC), swollen joint count (SJC) and laboratory tests were retrospectively collected from medical records. Disease activity was also assessed by the Juvenile Arthritis Disease Activity Score (JADAS). All data were checked for normality by the Kolmogorov-Smirnov test. The Spearman correlation was used for data analysis and p values less than 0.05 were considered statistically significant.ResultsA total of 54 consultations (29 at baseline and 25 at the last follow-up consultations) of 29 patients were included in our study. The mean age was 13.1±4.2 years [4-21] and the sex ratio of males to females was 1.07. JIA subtypes were: enthesis-related arthritis (n=12), polyarthritis (n=7), oligoarthritis (n=6), undifferentiated (n=3) and psoriatic arthritis (n=1). At baseline 51,73% of the patients were not under treatment, 34.49% were under non-steroidal anti-inflammatory drugs (NSAIDs) and 13.8% under methotrexate (MTX). At the last follow-up consultation 41.38% of the patients were under MTX, 34.49% under NSAIDS and 10.35% under Etanercept. At baseline, NLR1 was positively correlated with TJC1 (p=0.022, r=0.424) and SJC1 (p=0.014, r=0.453) but not with C-reactive protein CRP1 (p=0.512) neither erythrocyte sedimentation rate ESR1 (0.096) nor disease activity scores JADAS-CRP1 (p=0.063) and JADAS-ESR1 (p=0.091). PLR1 was positively correlated with SJC1 (p=0.004, r=0.521) and both disease activity scores JADAS-CRP1 (p=0.026, r=0.462) and JADAS-ESR1 (p=0.052, r=0.364). At the follow-up consultations only PLR2 was positively correlated to CRP2 (p=0.045, r=0.404). No correlation was noted between NLR2 and PLR2 and JADAS-CRP2 (p=0.281, p=0.063) and JADAS-ESR2 (p=0.324, p=0.082).ConclusionOur study suggests that NLR and PLR may be used as assessment tools of disease activity in patients with JIA. Further studies with larger sample sizes are needed to confirm these results and to explore the value of these ratios in the follow-up and the prognosis of JIA.Disclosure of InterestsNone declared

BackgroundJuvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatism of childhood. Diagnostic and therapeutic approaches are difficult for families to sustain with significant psychological and social effect.ObjectivesThe aim of this study is to understand the different challenges faced by families with children suffering from JIA.MethodsParents of children with JIA (according to the International League of Associations for Rheumatology (ILAR)) followed in rheumatology department were asked to complete a survey in order to screen the impact of their children’s disease on their family life. Open-ended questions and directed questions were included. General demographic and clinical information (family history of chronic inflammatory disease, child’s current age, diagnosis and type of JIA and, duration of disease progression) were also collected.ResultsThe study included 24 children with a gender-ratio of 1. The mean age was 12.4 years old [4-16]. The mean duration disease was 4 years with extremes varying from 3 months to 13 years. The frequency of each JIA subset was at follows: polyarticular with rheumatoid factor (n= 2), polyarticular without rheumatoid factor (n=5), psoriatic arthritis (n= 1), enthesitis-related arthritis (n=10) and oligoarthritis (n= 6). Twenty-four parents completed the survey. The mother was the one who answered the questions in 83% of the cases. Other family members with a chronic rheumatic disease were reported in 40% of the families.Parents noted negative impact on their work in 50% of cases (40% missing time from work, 10% changing work schedule) and, significant parental stress, anxiety, and fatigue in 75% of the cases. In 33% of the cases, parents had difficulty getting the required medical care and attention for their child’s illness because of financial issues and 37.5% of them were feeling anxiety regarding diagnosis uncertainty. Parents reported worry about their child’s daily functioning and future in 75% of the cases. They noted psychological impact on the child itself in 58% of the cases and child missing school in 41% of the cases. The most common resources parents used for information were health care professionals in 54.2 % of the cases and 45.8% of them got additional information from online research.ConclusionParents of children with JIA share common challenges due to their child’s illness including a substantial impact on their work and personal wellness in addition to the psychosocial impact of the disease on the child. Support groups or educational sessions may be needed to provide guidance for these families to cope with disease.Disclosure of InterestsNone declared

BackgroundSleep problems are common among children with chronic illnesses such as Juvenile Idiopathic Arthritis (JIA), which is one of the most common rheumatic diseases in childhood. Sleep disturbances collectively refer to impairments in the ability to initiate or maintain sleep. They can be measured by parent or child self-report and by objective measures such as actigraphy and polysomnography.ObjectivesThe aim of this study was to assess sleep disorders in children with JIA.MethodsParents of children suffering from JIA (according to the International League of Associations for Rheumatology (ILAR)), followed in rheumatology department were asked to complete a specific specialized scale for children (HIBOU) [1] to screen sleep disorders. This scale assesses five aspects of sleep: irregular schedule and daytime drowsiness, insomnia, moves in sleep, nose obstruction and ultra-vigilance. Parents were asked to answer 8 questions rated from 1 to 3 according to the frequency of the problem, 1: rarely, 2: 3 to 4 times a week and 3 if 5 to 7 times a week. If the sum is ≤ 9, only sleep hygiene is recommended. If the sum is between 10 and 15 the child requires regular supervision. If the sum is between 16 and 24, the child needs to be referred to a specialist. General demographic and clinical information (family history of chronic inflammatory disease, child’s current age, diagnosis and type of JIA, duration of disease progression and activity of the disease) were also collected.ResultsTwenty-four children with a mean age of 12 years [4-16] were included in the study. The gender ratio was 1. The mean duration of the disease was 4 years with extremes from three months to thirteen years. The frequency of each JIA subset was as follows: polyarticular with rheumatoid factor (n= 2), polyarticular without rheumatoid factor (n=5), psoriatic arthritis (n= 1), enthesitis-related arthritis (n=10) and oligoarthritis (n= 6). Irregular sleep schedule and daytime drowsiness were reported at least 3 times a week by 58.3% of the children. Insomnia and inability to initiate sleep were reported in 29.3% of the children at least 3 times a week. Parents reported exaggerated moves during sleep in 50% of the cases and airway obstruction or snoring in 58.3% more than 3 times a week. Difficulties to maintain a good night of sleep more than three times a week were reported in 25% of cases. To sum up, 29.2% of the children had a score above 15 and needed to be referred to a specialist and 58.3% of them need a regular supervision of their sleep and may need to be referred to a specialist. Only three children had a score under 9 and don’t have concerning sleep disorders according to this scale.ConclusionThis study showed that sleep disorders are a common challenge in children and adolescents with JIA which could have a huge impact on their physical and psychosocial health-related quality of life. This study highlights the need for assessment of sleep disorders in JIA patients.References[1]Benhaberou-Brun D. HIBOU: pour évaluer les troubles du sommeil [HIBOU: evaluating sleep disorders in children]. Perspect Infirm. 2011;8(6):35-37.Disclosure of InterestsNone declared