AB0748 ARE ANY DIFFERENCES BETWEEN JIA - ASSOCIATED UVEITIS, DEVELOPED BEFORE AND AFTER JOINT MANIFESTATION
Authors: M. Chakhalian, E. Gaidar, T. Nikitina, E. Isupova, I. Chikova, M. Dubko, V. Masalova, T. Likhacheva, L. Snegireva, M. Kaneva, O. Kalashnikova, V. Chasnyk, M. Kostik
Journal: Annals of the Rheumatic Diseases (2021)

Background: Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA). Usually uveitis developed during first two years after arthritis occurred [1]. In the previous studies was shown the shorter time interval between arthritis and uveitis the severe uveitis course was observed [2]. Information about course of uveitis developed before arthritis is scarce. Objectives: We aimed to evaluate the clinical features and therapy of JIA-associated uveitis, which developed before and after joint manifestation. Methods: In the retrospective study 191 pediatric autoimmune uveitis included. The onset age ranged from 1 to 17 years. We evaluated differences in clinical, laboratorial and treatment differences between groups, i) where uveitis developed before (n=58) and ii) after (n=133) arthritis. Chronic autoimmune uveitis without joint manifestations was excluded. Results: Uveitits before arthritis developed in 58 (30.4%) cases. Patients whom uveitis developed before arthritis had were elder and characterized equal gender involvement, rare ANA positivity, and rare use of immunosupression, e.g. corticosteroids, biologics and methotrexate, due to treatment by ophthalmologist predominantly. Patients developed uveitis before arthritis received biologics earlier due to severity of uveitis (LogRank test, p=0.016, HR=1.97 (95%CI: 1.3; 3.1, p=0.004). Data are in the Table 1 and Figure 1. Conclusion: Patients with JIA associated uveitis with initial ocular presentation demonstrated more severe course and delayed diagnostics and treatment due to lack of contacts with pediatric rheumatologist. Cooperation between ophthalmologist and pediatric rheumatologist is strictly required in all cases with chronic anterior uveitis. Table 1. Table 1. Parameter Uveitis before arthritis (n=58) Uveitis after arthritis (n=133) p Sex, female 32 (55,2) 97 (72,9) 0.016 Onset age, years 6.7 (4.6; 10.2) 3.2 (2; 6.1) 0.000001 JIA category Oligoarthritis 41 (70.7) 84 (63.6) 0.174 Polyarthritis 9 (15.5) 36 (27.3) Enthesytis-related arthritis 8 (13.8) 12 (9.1) Type of uveitis Anterior 44 (75.9) 111 (84.1) 0.315 Peripheral 3 (5.2) 2 (1.5) Posterior 3 (5.2) 3 (2.3) Panuveitis 8 (13.8) 16 (12.1) Unilateral uveitis, n (%) 19 (32.8) 48 (36.1) 0.632 ANA posititivity, n (%) 25/54 (46.3) 72/110 (65.5) 0.019 HLA B27 positivity, n (%) 8/35 (22.9) 13/62 (21.0) 0.828 Methotrexate, n (%) 3 (5.2) 57/132 (43.2) 0.0000001 Systemic corticosteroids, n (%) 3 (5.2) 44/131 (33.6) 0.00003 Biologic, n (%) 26 (44.8) 88 (66.2) 0.006 ESR, mm/h 19.0 (4.0; 25.0) 23 (15.0; 32.0) 0.095 CRP, mg/l 97.0 (0.1; 107.5) 8.1 (0.9; 57.4) 0.493 Time between arthritis and uveitis, years 2.7 (0.9; 4.3) 4.0 (2.0; 7.1) 0.016 Time before biologic, years 2.5 (0.9; 3.5) 1.3 (0.5; 5.0) 0.462 This work supported by the Russian Foundation for Basic Research (grant № 18-515-57001). References: [1]Verazza S, et al. Pediatr Rheumatol Online J 2008;6(Suppl 1):77. [2]Zannin ME, et al. Acta Ophthalmol 2012;90:91-5. Disclosure of Interests: None declared Figure 1.