Clinical Evolution of Patients Diagnosed of Juvenile Idiopathic Arthritis After the Transitional Care Consultation

Alba Maria Torrat Noves¹, Rebeca Perpiñan Perez², Jose Ivorra Cortes¹, Elena Grau Garcia¹, Daniel Ramos Castro¹, Pablo Francisco Muñoz Martínez³, Laura Mas Sanchez⁴, Carmen Riesco Barcena¹, Anderson Victor Huaylla Quispe¹, Samuel Leal Rodriguez¹, Belen Villanueva Mañez¹, Iago Alcantara Alvarez¹, Isabel Martinez Cordellat¹, Luis Gonzalez Puig¹, Rosa Negueroles Albuixech¹, Jose Eloy Oller Rodriguez¹, Elvira Vicens Bernabeu¹, Ernesto Tovar Sugrañes¹, Marta De la Rubia Navarro⁴, Hikmat Charia¹, Ines Canovas Olmos¹, Carmen Najera Herranz¹ and Jose Andres Roman Ivorra⁵, ¹Rheumatology Department. HUP La Fe, Valencia, Spain, ²Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain, ³Rheumatology Department. HUP La Fe, Sagunto, Spain, ⁴Rheumatology Department. HUP La Fe, Valéncia, Spain, ⁵Hospital Universitari i Politècnic la Fe, Valencia, Spain

Meeting: ACR Convergence 2023

Keywords: Juvenile idiopathic arthritis, Pediatric rheumatology

Session Information

Date: Sunday, November 12, 2023

Title: (0345–0379) Pediatric Rheumatology – Clinical Poster I: JIA

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Juvenile idiopathic arthritis (JIA) encompasses a group of chronic arthritis that begin in childhood. According to the International League of Associations for Rheumatology (ILAR) criteria, JIA can be divided into seven distinct groups: oligoarthritis, rheumatoid factor (RF) negative and positive polyarthritis, enthesitis related arthritis, psoriatic arthritis, systemic arthritis and undifferentiated arthritis.

Following their visit to the transitional consultation, these patients subsequently undergo clinical follow-up in adult rheumatology.

The objective of this study is to describe the evolution of clinical and analytical findings, as well as treatment data in patients with JIA after the transitional care consultation.

Methods: Descriptive, longitudinal, and retrospective study conducted on 70 patients diagnosed with JIA based on the ILAR criteria. These patients were followed-up in adult rheumatology consultations after being visited in the transitional consultation at a Spanish tertiary-level hospital. Data pertaining to clinical, laboratory, and treatment aspects were collected from both the adult and transitional consultations.

Results: 70 patients diagnosed of JIA (65.7% women) were included in the study, with a mean age at diagnosis of 9 years old and a mean age at the transitional consultation of 21 years. The average duration of follow-up after the initial diagnosis was 16 years, while the mean duration of follow-up after the transitional consultation was 4 years.

After the transitional consultation, 12.8% of the patients had a change in their diagnosis (table nº 1).

24 patients (34.3%), were lost to follow-up, primarily due to changes in the health department in the majority of cases.

Half of the patients with history of previous uveitis experienced new episodes following the transitional consultation. In contrast, a significant number of patients did not experience recurrences during their follow-up in adult rheumatology appointments (table n º 3). 100% of the patients who had new flares of uveitis after the transitional consultation had ANA+ in serum.

The frequency of oral and genital thrush, Raynaud phenomenon and diarrhea episodes decreased after the transitional consultation.

Out of the 28 patients who were in remission without treatment during the transitional care consultation, only 1 patient required initiation of therapy during their follow-up in adult rheumatology appointments.

Conclusion: 12.8% of the patients experienced a change in their diagnosis during their follow-up in the adult rheumatology consultation, with the majority of these cases being classified as undifferentiated JIA.

The majority of patients who were in remission without treatment during the transitional consultation did not require treatment during their follow-up in adult rheumatology appointments.

A significant number of patients experienced recurrences of uveitis after the transitional care consultation. However, new cases of uveitis in patients who had not previously experienced episodes were rare during the follow-up in adult rheumatology appointments.

Diagnosis changes

Cumulative incidence of clinical and analytical manifestations

Evolution of clinical and analytical manifestations

Disclosures: A. Torrat Noves: None; R. Perpiñan Perez: None; J. Ivorra Cortes: None; E. Grau Garcia: None; D. Ramos Castro: None; P. Muñoz Martínez: None; L. Mas Sanchez: None; C. Riesco Barcena: None; A. Huaylla Quispe: None; S. Leal Rodriguez: None; B. Villanueva Mañez: None; I. Alcantara Alvarez: None; I. Martinez Cordellat: None; L. Gonzalez Puig: None; R. Negueroles Albuixech: None; J. Oller Rodriguez: None; E. Vicens Bernabeu: None; E. Tovar Sugrañes: None; M. De la Rubia Navarro: None; H. Charia: None; I. Canovas Olmos: None; C. Najera Herranz: None; J. Roman Ivorra: None.

To cite this abstract in AMA style:

Torrat Noves A, Perpiñan Perez R, Ivorra Cortes J, Grau Garcia E, Ramos Castro D, Muñoz Martínez P, Mas Sanchez L, Riesco Barcena C, Huaylla Quispe A, Leal Rodriguez S, Villanueva Mañez B, Alcantara Alvarez I, Martinez Cordellat I, Gonzalez Puig L, Negueroles Albuixech R, Oller Rodriguez J, Vicens Bernabeu E, Tovar Sugrañes E, De la Rubia Navarro M, Charia H, Canovas Olmos I, Najera Herranz C, Roman Ivorra J. Clinical Evolution of Patients Diagnosed of Juvenile Idiopathic Arthritis After the Transitional Care Consultation [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/clinical-evolution-of-patients-diagnosed-of-juvenile-idiopathic-arthritis-after-the-transitional-care-consultation/. Accessed .

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