Fri0561 comparison of Initial Presentations Between Juvenile Idiopathic Arthritis Children With Systemic Onset With Non-Biologic Monocyclic and Persistent Courses

Abstract

BackgroundJuvenile idiopathic arthritis with systemic onset (soJIA) may have monocycling, polycycling or relapsed course [1]. There were not known soJIA course predictors.ObjectivesThe aim of our study was to evaluate initial clinical or laboratory features of the patients with soJIA who had monocyclic course without biologics.MethodsIn the present study were included data about 130 soJIA patients. After selection we identified a subgroup of the soJIA patients (n=22) who successfully achieved remission without any biologic medication and were stable in the remission off-medication at least two years. The second group consisted of the patients with chronic persistent course (n=83). The remained 25 patients were excluded due to missing data or who did not meet the selection criteria. We evaluated routine clinical (fever, rash, hepatosplenomegaly, serositis, lymphadenopathy, MAS, joint involvement) and laboratorial (WBC, PLT, Hb, ferritin, ALS, AST, LDH, GGTP, ALP, albumin, Na, triglycerids, ESR, CRP, prothrombin, fibrinogen) soJIA features in the onset of the disease.ResultsPatient with monocycling course have no any differences except the ferritin level: 275 (133; 698) ng/ml vs 950 (150; 3240) ng/ml, (p=0.04), time to achievement remission 17.7 (8.2; 38.0) months vs 60.2 (36.0; 99.0) months (p=0.00002) and rare elbow involvement 4.6% vs 30.9% (p=0.01). The parameters, associated with possible monocycling course are in the table.Table. The parameters, associated with possible monocyclic course in soJIA patients.ParameterAUC (95%CI)SeSpOR (95% CI)pCRP≤3.1 mg/dl0.59 (0.48; 0.69)0.530773.6 (1.3; 10.3)0.014ESR≤ 53 mm/h0.62 (0.51; 0.71)0.90.436.8 (1.5; 31.3)0.006Ferritin ≤1340 ng/ml0.69 (0.58; 0.79)1.00.46-0.003Active joints < 80.5 (0.4; 0.6)0.820.394.6 (1.3; 16.8)0.013Onset age <7 years0.57 (0.47; 0.66)0.860.44.2 (1.5; 15.3)0.022No elbow involvement, n (%)-0.960.319.4 (1.2; 73.6)0.012ConclusionPatients with soJIA initially have quit similar clinical presentations independently the further clinical course. The prediction of possible course of soJIA is a difficult problem. Patients with soJIA with monocycling course were younger and had less impressive laboratory activity. Further investigations required.Reference:[1] Cimaz R. Systemic-onset juvenile idiopathic arthritis. Autoimmun Rev. 2016;15(9):931-4.Disclosure of InterestsNone declared