Session Information
Session Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects: Juvenile Idiopathic Arthritis
Session Type: Abstract Submissions (ACR)
Background/Purpose The epidemiology of juvenile idiopathic arthritis (JIA) is known to be variable worldwide and the therapeutic approach to JIA is not standardized. Moreover, the availability of the novel and costly biologic medications is not uniform throughout the world, with possible significant impact on disease prognosis. The EPOCA study is aimed to obtain information on the frequency of JIA subtypes in different geographic areas, the therapeutic approaches adopted, and the disease status of children with JIA currently followed worldwide.
Methods So far, 124 centers in 55 countries have agreed to participate in the study. Participation in the study was proposed to the pediatric rheumatology center of all countries belonging to the Pediatric Rheumatology International Trials Organization (PRINTO), and to several centers in the US and Canada. Each centre was asked to enroll 100 consecutive JIA patients or, if less than 100, all consecutive patients seen within 6 months. Each patient received a retrospective and cross-sectional assessment. Parent- and child-reported outcomes were recorded through the administration of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Participating countries were grouped into 6 geographic areas.
Results Currently, 6,940 patients from 41 countries have been entered in the web database. Comparison of data from the different geographic areas is presented in the table.
|
Africa N = 79 |
Asia N = 726 |
Eastern Europe N = 2171 |
Latin America N = 795 |
North America N = 243 |
Western Europe N = 2845 |
|
|
JIA onset age, yrs, median (IQR) |
5.7 (2.8; 10) |
5.9 (2.9; 9.5) |
6.3 (2.8; 10.4) |
6.6 (3.5; 10.3) |
7.5 (3.2; 11) |
4 (2; 8.7) |
|
Systemic arthritis, N (%) |
11 (13.9) |
174 (24) |
165 (7.6) |
143 (18) |
16 (4.9) |
202 (7.1) |
|
Oligoarthritis, N (%) |
25 (31.6) |
256 (35.3) |
958 (44.1) |
247 (31.1) |
103 (31.8) |
1398 (49.1) |
|
Enthesitis related arthritis, N (%) |
3 (3.8) |
92 (12.7) |
248 (11.4) |
74 (9.3) |
35 (10.8) |
253 (8.9) |
|
Uveitis, N (%) |
4 (5.1) |
40 (5.5) |
232 (10.7) |
51 (6.4) |
38 (11.7) |
495 (17.4) |
|
JADAS10, median (IQR) |
5 (1.5; 10) |
3.5 (0.5; 10) |
5 (1; 10.6) |
3.5 (0; 10.8) |
2 (0; 5.5) |
2 (0; 6.3) |
|
Inactive disease, N (%) |
13 (16.5) |
237 (32.6) |
454 (20.9) |
268 (33.7) |
114 (35.2) |
1070 (37.6) |
|
JADI articular > 0, N (%) |
27 (34.2) |
136 (18.7) |
531 (24.5) |
257 (32.3) |
60 (18.5) |
352 (12.4) |
|
Treated with biologics, N (%) |
27 (34.2) |
134 (18.5) |
637 (29.3) |
273 (34.3) |
178 (54.9) |
1067 (37.5) |
Conclusion Patients seen in Western Europe have a younger age at onset and a greater prevalence of uveitis. Systemic arthritis is more common in Asian patients, whereas enthesitis related arthritis is less frequent in African patients. Children from Africa and Eastern Europe have a higher level of disease activity and a lower frequency of inactive disease, and African and Latin American patients have a greater prevalence of articular damage. Biologic medication are administered more frequently in North America and less commonly in Asia.
Disclosure:
A. Consolaro,
None;
A. Aggarwal,
None;
T. Herlin,
None;
O. Vougiouka,
None;
R. Burgos-Vargas,
None;
I. Orban,
None;
N. Shafaie,
None;
M. Trachana,
None;
L. Rutkowska-Sak,
None;
I. Rumba-Rozenfelde,
None;
D. Mihaylova,
None;
A. Martini,
None;
A. Ravelli,
None.
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