THU0587 Clinical and therapeutic aspects of a south asian population of systemic onset juvenile idiopathic arthritis in a tertiary care peadiatric rheumatology centrein sri lanka
Authors: M. Adikari, A. Subasinghe, M. de Silva
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic onset juvenile idiopathic arthritis is a rare multisystem inflammatory disease of childhood associated with significant morbidity and mortality. Sri Lanka is a country situated in south Asia. Disease characteristics of systemic onset juvenile idiopathic arthritis is not well studied in this geographical region. Sri Lanka offers public funded free universal healthcare for all citizens including biological disease modifying drugs. Lady Ridgway hospital for children is the national centre for tertiary peadiatric care and draws patients from wider geographical territory of Sri Lanka. <h3>Objectives</h3> To describe the demographic parameters, clinical features, disease activity and therapeutic aspects of systemic onset juvenile idiopathic arthritis among a population of Sri Lankan patients. <h3>Methods</h3> A descriptive cross sectional study was conducted at the department of rheumatology at Lady Ridgway hospital for children. Systemic onset juvenile idiopathic arthritis patients of 1–16 years of age, with minimum 6 months follow up in the study centre were recruited. Patients' demographic, clinical and laboratory data were collected. <h3>Results</h3> Data of 32 patients were analysed. Eleven (34.4%) were males and 21 (65.6%) were females. Mean age was 9.3 years (SD=4.19) while mean age at diagnosis was 5.95 years (SD=3.35). Majority n=17 (55%) had polyarthritis at the onset while n=12 and n=2 showed oligo-arthritis and mono-arthritis respectively. Mean inflammatory joint count at presentation was 5.4 (SD=3.7). Fifteen (46.9%) patients had persistent disease while 11 (34.4%) showed monocyclic and 6 (18.7%) had polycyclic disease pattern. Mean erythrocyte sedimentation rate of the study population at diagnosis was 104 0.2 mm/1st hour, dramatically reduced to 43.9 mm/1st hour after 6 months of treatment. All patients received corticosteroids for variable durations and doses during the disease course. Methotrexate was given to majority of patients (n=25, 78.1%). Thirteen patients (40.6%) received Tocilizumab. Disease remission was achieved by majority of 18 (56.2%) patients. All eligible patients received biological disease modifying drugs when indicated. Mean JDAS 10 score of the population was 4.4. <h3>Conclusions</h3> The above study revealed important demographic data, clinical features and therapeutic aspects of a population of systemic onset juvenile idiopathic arthritis in a tertiary care peadiatric rheumatology centre in a south Asian population in Sri Lanka. Majority of patients were able to achieve remission or low disease activity with treatments. <h3>References</h3> [1] Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton 2001. J Rheumatol2004;31:390–2. [2] Modesto C, J. Antón B, Rodriguez, et al. Incidence and prevalence of juvenile idiopathic arthritis in Catalonia (Spain): Scandinavian Journal of Rheumatology2010;39(6):472–479. [3] Gunatillaka KAN, de Silva MKK. Juvenile idiopathic arthritis: An observational study, Sri Lanka Journal of Child Health2007;36:96–101. [4] Consolaro A, Ruperto N, Bazso A, et al. Development and validation of a composite disease activity score for juvenile idiopathic arthritis. Arthritis Rheum2009; 61:658–6. <h3>Disclosure of Interest</h3> None declared