Ab1412 the damage of juvenile idiopathic arthritis in adult patients

Background Juvenile idiopathic arthritis (JIA) is the most common disease in pediatric rheumatology. After transition, chronic active JIA requires continuing treatment. Little is yet known about the JIA activity in adult patients. Objectives To assess disease activity, treatment and comorbidities in adult patients with JIA between 2000 and 2022 at the University Hospital of Heidelberg. Methods This is a monocentric, retrospective analysis of adult patients with onset as JIA. The electronic medical records were analyzed from the first to the last documented visit in our center. Prognostic factors for disease activity in adults were determined using Fisher’s exact test, chi-square test and cross tables. Results Until March 2022, 172 JIA patients with a median age of 27.7 years (range 18.1 to 78.4) and a median disease duration of 19.4 years (range 1.3 to 68.8) at their last visit were identified. Oligoarticular (oligo-) (n=36, 20.9%), extended-oligo (ext-oligo-) (n=28, 16.3%) and polyarticular (poly-) (n=61, 35.5%) were the largest JIA subgroups. Females (n=134, 77.9%) were more prevalent than males (n=38, 22.1%) (p<0,001). The prevalence of uveitis was 27.9% (n=48). Patients with RF+ poly-JIA (n=17, p<0,001) or initiation of MTX after 2 years (n=41, p=0,006) or bDMARD after 3 years (n=44, p<0,001) of disease onset were associated with significantly more erosive joint damage. Patients with late MTX and/or bDMARD initiation (n=190) had more frequently osteoporosis (n=48, p=0,011, p=0,012) and required more frequently total joint replacement (n=41, p=0,012, p=0,04). Radiological joint damage was more prevalent in patients with a disease onset before the year 2000. At the last documented visit 51.8% of patients (n=72) were in SDAI and DAS28 remission. Conclusion The delay of MTX and bDMARD therapy in patients with active JIA was associated with erosive joint damage, total joint replacement and osteoporosis. The JIA onset before the year 2000 was associated with significantly more joint damage and a lower prevalence of remission. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.