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Abstract Number: 928

A Multinational Study of the Epidemiology, Treatment and Outcome of Childhood Arthritis: Preliminary Data from 6,940 Patients

Alessandro Consolaro1, Amita Aggarwal2, Troels Herlin3, Olga Vougiouka4, Rubén Burgos-Vargas5, Ilonka Orban6, Nahid Shafaie7, Maria Trachana8, Lidia Rutkowska-Sak9, Ingrida Rumba-Rozenfelde10, Dimitrina Mihaylova11, Alberto Martini12,13 and Angelo Ravelli1,14, 1Pediatria II, Istituto Giannina Gaslini, Genova, Italy, 2Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, 3Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark, 4P. A. Kyriakou Childrens Hospital of Athens University, Athens, Greece, 5Hospital General de Mexico, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico, 6National Institute of Rheumatology and Physiotherapy, Budapest, Hungary, 7Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran, 8Aristotle University, Thessaloniki, Greece, 9Institute of Rheumatology, Warsaw, Poland, 10University of Latvia, Riga, Latvia, 11University Children Hospital, Sofia, Bulgaria, 12Istituto Giannina Gaslini, Genova, Italy, 13University of Genova, Genova, Italy, 14Istituto Giannina Gaslini and University of Genova, Genova, Italy

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: classification criteria, Epidemiologic methods, juvenile idiopathic arthritis (JIA), outcomes and treatment

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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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