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Abstract Number: 2314

Monoarticular Juvenile Idiopathic Arthritis: A Unique Entity?

Caterina Politi1, Vanessa Cecchin1, Fabio Vittadello1, Alessandra Meneghel2, Giorgia Martini1 and Francesco Zulian2, 1Department of Woman and Child Health, University of Padua, Padua, Italy, 2University of Padua, Department of Woman and Child Health, Padua, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: classification criteria, juvenile idiopathic arthritis (JIA), outcomes, therapy and uveitis

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Session Information

Date: Tuesday, November 7, 2017

Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects Poster III: Juvenile Arthritis

Session Type: ACR Poster Session C

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

Background/Purpose: Oligoarticular Juvenile Idiopathic Arthritis (oligoJIA) is the most common JIA subtype. According with the most recent classification criteria1, monoarticular JIA (monoJIA) is included in the oligoarticular subgroup. We investigated whether patients with persistent monoJIA have different clinical features and outcome as compared to those with oligoarticular disease.

Methods: We evaluated patients with oligoJIA followed at our Pediatric Rheumatology tertiary Center and at least one year of disease duration. MonoJIA we selected on the basis of the exclusive involvement of one single joint during the overall disease course. Each patients was followed with check visits, including ophthalmologic evaluation, every 3-4 months. For each patient, the following parameters were considered: sex, age at onset, presence of joint hypermobility (JH) according to Beighton’s criteria2, family history positive for JH, ANA (titer > 1/80 on Hep2 cells), presence and localization of active arthritis, presence of uveitis, treatment during the overall course of the disease and outcome. Treatment was grouped in four categories: intra-articular corticosteroid injection (IACs), non-steroidal anti-inflammatory drugs and/or oral corticosteroids (AIDs), MTX and other disease-modifying anti-rheumatic drugs (DMARDs), and biological agents (BAs). Outcome was defined according to Wallace criteria3 as: clinical remission (CR), clinical remission on medication (CRM) and active disease (A).

Results: 356 patients with oligoJIA, as defined by the ILAR criteria, entered the study. Among these, 23 were excluded for lack of complete data and 12 for follow-up shorter than 1 year. Among the remaining 321, followed for mean 7,6 years (1-21.7), 227 (70.7%) presented oligoJIA and 94 (29.3%) monoJIA. MonoJIA resulted significantly different from oligoJIA for the higher frequency of JH, positive family history for JH, lesser frequency of ANA+ and uveitis and for the less aggressive treatment and better long-term outcome.(Table 1)

Conclusion: MonoJIA seems to be a separate nosological entity from oligoJIA with less incidence of ANA, less uveitis and better long-term outcome. A different treatment approach should be therefore foreseen.

References

  1. Petty RE, et al. J Rheumatol 2004;31:390-392
  2. Beighton P, et a. Ann Rheum Dis. 1973; 32: 413–418.
  3. Wallace CA, et al. J Rheumatol. 2004;31:2290-2294

Table 1

Mono JIA

(no.94)

Oligo JIA

(no.227)

p

Sex (female)

72 (76,6%)

189 (83,3%)

0,16

Age at onset (years, months)

5,7

4,7

0,06

Joint Hypermobility (JH)

68 (73,1%)

135 (61,4%)

0,04

Positive family history of JH

18 (56,3%)

29 (31,2%)

0,01

ANA+

72 (76,6%)

198 (87,2%)

0,02

Uveitis

19 (20,2%)

72 (31, 7%)

0,03

Treatment

IACs

AIDs

DMARDs

BAs

86 (91,5%)

19 (20,2%)

17 (18,1%)

3 (3,2%)

214 (94,3%)

137 (60,4%)

165 (72,7%)

57 (25,1%)

0,000

Outcome

CR

CRM

A

76 (80,9%)

12 (12,8%)

6 (6,4%)

73 (32,3%)

98 (43,2%)

56 (24,7%)

0,000


Disclosure: C. Politi, None; V. Cecchin, None; F. Vittadello, None; A. Meneghel, None; G. Martini, None; F. Zulian, None.

To cite this abstract in AMA style:

Politi C, Cecchin V, Vittadello F, Meneghel A, Martini G, Zulian F. Monoarticular Juvenile Idiopathic Arthritis: A Unique Entity? [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/monoarticular-juvenile-idiopathic-arthritis-a-unique-entity/. Accessed .
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