The Proposed Outcome Parameters of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC) with Uveitis Disability VAS Score Correspond Significantly with Uveitis "Classicaly Assessed" Uveitis Activity

Ivan Foeldvari¹, Sandra Schenck², Gabriele Simonini³, Cinzia DeLibero⁴, Gabriele Brumm⁵, Kaisu Kotaniemi⁶, Susan Mary Nielsen⁷, Regitze Bangsgaard⁷, Irene Pontikaki⁸, Valeria Maria Gerloni⁸, Elisabetta Miserocchi⁹, Vasco Miranda¹⁰, Margarida Guedes¹¹, Sheila T. Angeles-Han¹², Steven Yeh¹³, Jordi Anton¹⁴, Rosa Bou Torrent¹⁵, Carmen García de Vicuña¹⁶, Martina Niewerth¹⁷ and Arnd Heiligenhaus¹⁸, ¹Hamburger Zentrum für Kinder-und Jugendrheumatologie, Hamburg, Germany, ²Deutsches Rheuma-Forschungszentrum, Berlin, Germany, ³Pediatric Rheumatology, Pediatric Rheumatology Unit, Anna Meyer Children's Hospital-University of Florence, Firenze, Italy, ⁴Ophthalmology Unit, Anna Meyer Children's Hospital, Florence, Italy, ⁵Klinik und Polyklinikum für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany, ⁶Ophthalmology Department, Rheumatism Foundation Hospital, Heinola, Finland, ⁷Rigshospitalet, Copenhagen, Denmark, ⁸Dipartimento di Reumatologia, Università di Milano - Istituto Gaetano Pini, Milano, Italy, ⁹Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy, ¹⁰Centro Hospitalar do Porto, Porto, Portugal, ¹¹Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal, ¹²Pediatrics, Emory Children's Center, Atlanta, GA, ¹³Ophthalmology, Emory University School of Medicine, Atlanta, GA, ¹⁴Unitat de Reumatologia Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain, ¹⁵Pediatrics Department, Pediatric Rheumatology Unit, Universitat de Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain, ¹⁶Universitat de Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain, ¹⁷Epidemiology, German Rheumatism Research Centre, Berlin, Germany, ¹⁸Department of Ophthalmology at St. Franziskus Hospital Muenster, University of Duisberg-Essen, Muenster, Germany

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: juvenile idiopathic arthritis (JIA), outcome measures and uveitis

Session Information

Date: Monday, November 9, 2015

Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects Posters. Juvenile Arthritis and Miscellaneous Rheumatic Diseases

Session Type: ACR Poster Session B

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

Background/Purpose:

Juvenile idiopathic arthritis (JIA) associated uveitis is one of the most severe comorbidities of JIA and occurs in around 10% of JIA patients. There are currently no specific established outcome measures for this specific uveitis. The Standardization of Uveitis Nomenclature (SUN) group made the first attempt to establish outcome measures for uveitis, which were not aimed at JIA associated Uveitis. Adopting part of it, we developed and proposed specific outcome measures for JIA associated Uveitis over a consensus process specific for JIA associated uveitis. Here we are presenting the results of the validation study.

Methods:

Patients were considered eligible, if they started a nonbiologic or biologic disease modifying agent , as indicated by active the uveitis. At baseline, follow up at 3 months and at 6 months following parameters were collected: demographics, rheumatologic assessment (JIA type, activity of arthritis, JIA-related disability), ophthalmologic assessment (duration of uveitis, activity and damage of uveitis,visual acuity, ocular complications, topical and systemic medications, surgical procedure, uveitis-related disability).

Results:

Sixtynine patients were included in the study and up till now 38 patients had a complete follow-up for 6 months. 50/69 (72.5%) of the patients were female. The mean age at inclusion into the study was 8.0 years (range 3-18 years). 98% of the patients were Caucasian. The JIA subset distribution was 56.3% oligoarticular, 14.1% extended oligoarticular, 18.8 % RF negative polyarticular and 4.7% enthesitis related. At inclusion the median disease duration of JIA was 55 months for arthritis and 32.5 months for uveitis. All patients had anterior uveitis. The left eye was more frequently involved (90.3%) then the right eye (83.6 %). Cellcount at baseline was +0.5 or more in 68.3 % of the right eyes and 62.3% of the left eyes, and at 6 months only 30.6% the left eyes. The cell count before dilatation (p=0.005) and after dilatation (p<0.001) improved significantly over time. Flare was ≥ 0.5+ (graded by SUN) at baseline in the right eyes in 76.7% and in the left eyes 70.2% and at 6 months at the right eyes in 21.2% and the left eyes in 23.5%. The flare grade according SUN (p<0.001) improved significantly comparing time point zero to 6 months. The flare grad according MIWGUC;flare >0.5 in 82.4% at time point 0 and after 6 months 35.3%, improved singifiacnatly to (p=0.021). The VAS score (0-100) for uveitis related disability decreased from 43.2 to 18.8 (p=0.001) and JIA associated disability, decreased from 33.3 to 8.0 (p< 0.001). The assessed complication of uveitis decreased from 86.7% to 61.9% after 6 months follow up (p=0.102).

Conclusion:

These results regarding the standardized assessment of the JIA associated uveitis are promising. The newly suggested Uveitis disability score showes significant correlation with cell count and flare grade after 6 months. Further evaluation of these items and the other suggested items will help to establish standardized measures to assess the activity of uveitis and the effecacy of a drug in treatment trials. The assessment of the newly published JIA associated Uveitis QOL is planned.

Disclosure: I. Foeldvari, None; S. Schenck, None; G. Simonini, None; C. DeLibero, None; G. Brumm, None; K. Kotaniemi, None; S. M. Nielsen, None; R. Bangsgaard, None; I. Pontikaki, None; V. M. Gerloni, None; E. Miserocchi, None; V. Miranda, None; M. Guedes, None; S. T. Angeles-Han, None; S. Yeh, None; J. Anton, None; R. Bou Torrent, None; C. García de Vicuña, None; M. Niewerth, None; A. Heiligenhaus, None.

To cite this abstract in AMA style:

Foeldvari I, Schenck S, Simonini G, DeLibero C, Brumm G, Kotaniemi K, Nielsen SM, Bangsgaard R, Pontikaki I, Gerloni VM, Miserocchi E, Miranda V, Guedes M, Angeles-Han ST, Yeh S, Anton J, Bou Torrent R, García de Vicuña C, Niewerth M, Heiligenhaus A. The Proposed Outcome Parameters of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC) with Uveitis Disability VAS Score Correspond Significantly with Uveitis “Classicaly Assessed” Uveitis Activity [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-proposed-outcome-parameters-of-the-multinational-interdisciplinary-working-group-for-uveitis-in-childhood-miwguc-with-uveitis-disability-vas-score-correspond-significantly-with-uveitis-classica/. Accessed .

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