SAT0508 Prevalence of Uveitis and Related Secondary Complications in Juvenile Idiopathic Arthritis
Authors: J. Klotsche, K. Minden, S. Schenck, M. Niewerth, T. Hospach, J.-P. Haas, R. Berendes, G. Ganser, A. Heiligenhaus, C. Tappeiner
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Uveitis is one of the most threatening complications in juvenile idiopathic arthritis (JIA). It occurs in approximately 10% of all JIA patients. Whether the frequency of uveitis in JIA has decreased over time as a result of the widespread use of immunosuppressive substances, is still an open question. Few data on the occurrence of JIA-associated uveitis and related secondary complications are available from population-based studies. <h3>Objectives</h3> To determine the change in uveitis prevalence and related secondary complications in patients with JIA between 2002 and 2013. <h3>Methods</h3> Data source for this study was the National Paediatric Rheumatological Database (NPRD). Uveitis onset, disease characteristics and details on treatment were provided by rheumatologists once a year. Ophthalmologists reported about uveitis characteristics such as eye involvement, uveitis activity and eye complications in detail in a specific uveitis add-on module. Data from the years 2002 to 2013 were used to determine the annual prevalence of uveitis and frequency of secondary complications. Two-level random effect models were used for investigating the change between 2002 and 2013. <h3>Results</h3> A total of 60 centers included 18,555 JIA patients, which were recorded in the NPRD between 2002 and 2013. The mean age of the patients was 11.4±4.6 years, their mean disease duration 4.4±3.7 years. 66.9% were female and 51.7% ANA positive. Patients9 mean age at arthritis onset was 6.9±4.5 years. In a multivariable regression analysis, the following risk factors for uveitis were identified: oligoarthritis (OR=4.21, p&lt;0.001), and ANA positivity (OR=2.61, p&lt;0.001), a higher disease activity measured by the cJADAS-10 (OR=1.02, p=0.001), whereas higher age at JIA onset was negatively associated with the onset of uveitis (OR=0.90, p&lt;0.001). Treatment rates with conventional and biological DMARDs increased during the observation period (csDMARD: 39.8% to 47.2%, bDMARD: 3.3% to 21.8%). Uveitis prevalence significantly decreased from 2002 to 2013 (13.0% to 11.6%, OR =0.98, p&lt;0.015). The prevalence of secondary uveitis complications also significantly decreased between 2002 and 2013 (33.6% to 23.9%, OR=0.94, p&lt;0.001). Among the complications, the most common complications were posterior synechiae (2002: 40.6%; 2013: 46.7%), cataract (2002: 40.6%; 2013: 29.3%) and band keratopathy (2002: 42.2%; 2013: 13.3%). The percentage of patients with inactive uveitis significantly increased from 30.6% in 2002 to 65.3% in 2013 (OR=1.15, p&lt;0.001). Visual acuity of the worse eye also improved over time, in fact a relevant visual loss of &lt;20/50 was found in 36.7% of uveitis cases in 2002 compared to 8.0% in 2013. <h3>Conclusions</h3> Uveitis prevalence and the frequency of secondary complications significantly decreased between 2002 and 2013. Both were correlated with a more frequent use of DMARDs. <h3>Acknowledgements</h3> The study was supported by a grant from Pfizer Pharma GmbH Germany (Forschungsförderung Rheumatologie). The national pediatric database is financially supported by the Children9s Arthritis Foundation (Kinder-Rheumastiftung). <h3>Disclosure of Interest</h3> J. Klotsche: None declared, K. Minden: None declared, S. Schenck: None declared, M. Niewerth: None declared, T. Hospach Speakers bureau: Pfizer, Abbvie, J.-P. Haas: None declared, R. Berendes: None declared, G. Ganser Grant/research support from: Abbott, Actelion, Pfizer, A. Heiligenhaus Grant/research support from: AbbVie, Pfizer, Novartis, and Deutsche Forschungsgemeinschaft, and has received study fees from AbbVie, Alimera Sciences, Allergan, Santen, and XOMA., C. Tappeiner Grant/research support from: Swiss Foundation for Grants in Biology and Medicine (SFGBM), Swiss National Science Foundation (SNSF) and Novartis.