AB1445 THE UNITED ARAB EMIRATES JUVENILE IDIOPATHIC ARTHRITIS REGISTRY PRELIMINARY RESULTS OF PATIENT DEMOGRAPHICS, SUBTYPE DISTRIBUTION, CLINICAL FEATURES, TREATMENT AND OUTCOME.

Background

Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory disease that affects 1 in 1000 children worldwide. Our population in the United Arab Emirates is a multiethnic diverse population. ^{[1, 2]}

Objectives

To create centralised data for JIA in the United Arab Emirates. In this abstract we describe the Demographic data, clinical features, subtype distribution as per ILAR classification, treatment received and outcome of our patients.^[3]

Methods

Retrospective entry of data from all 3 participating centres (Shaikh Shakhbout Medical City, Tawam and AlJalila). Patients with the diagnosis of JIA included. Electronic clinical research form used to collect data. Data at initial diagnosis and current outcome as per Wallace and (Juvenile Arthritis Disease Activity Score) JADAS 10. Long term out come as per Juvenile Arthritis Disease Activity (JADAI) articular > 0 and extra articular JADAI > 0. All data entered and analysed through Redcap (Research Electronic Data Capture web-based application version 12.1.1 model 2022). Simple statistics used. Ethics approval obtained.

Results

157 patients entered in to the registry so far. Male to female distribution: 39 (24.8%) to 118 (75.2%). Local Emirati patients of 107 (68.2%). Other Arabs 16 (10.2%). South Asian 12 (7.6%), Western 12 (7.6%) and African 10 6.4%). Mean age at presentation 5.3 years (1 to 15 years). Current mean age 12 (4-22 years). Family history of Rheumatoid Arthritis in 33 patients (21%). History of Consanguinity in 54 families (34.4%). Subtype distribution: Oligo articular 77 (49.4%), extended Oligo articular 5 (3.2%). Poly articular 50 (32.1%), Systemic 11 (7.1%), Enthesitis related Arthritis 1 (0.6%), Psoriatic 9 (5.8%) and other 3 (1.9%). At presentation: Joint pain in 132 patients (84.1%), Joint effusion 115 (73.2%). Affected function in 98 (63.2%). Clinical synovitis in 138 (87.9%). Joint restriction in 100 (63.7%). Uveitis in 6 (3.8%) ANA positive 35 patients (22.3%). Rheumatoid factor positive 10 (6.4%), Anti CCP positive 6 (3.8%). Low Hb less than 10 g/L in 109 (69.4%), high ESR > 20 mm/hr in 30 patients (19.1%). High CRP >5 mg/L in 48 (30.6%). Synovitis in USS 53 (33.8%). Erosions by X-ray or USS 7 patients (4.5%). Uveitis after diagnosis in 30 patients 19.1%. Dental carries at presentation in 51 patients (32.1%). COVID infection in 74 patients (47.1%). Oral systemic steroids given to 108 patients (68.8%). Intravenous methyl prednisolone to 43 patients 27.4%). Triamcinolone Acetonide/Hexa acetonide joint injections to 91 patients (58%). Synthetic Disease modifying medication methotrexate in 108 (68.8%). Biologic treatment 76 patients (49%). Etanercept 64 patients (40.8%), Adalimumab 65 patients (41.4%), Tocilizumab intra venous 32 (20.4%) and sub cut in 10 patients (6.4%). Canakinumab 9 patients (5.7%), Anakinra 8 patients (5.1%) and Infliximab in 10 patients (6.4%). Oral Tofacitinib in 2 patients (1.3%). In regards to outcome as per Wallace criteria and JADAS 10; active disease in 16 patients (10.2%). In remission 141 patients (89.8%). Out of these in remission on treatment 118 (83.7%) and in remission off treatment 23 patients (16.3%). JADAI articular >0 in 8 patients (5%) and JADAI extra articular >0 in 14 patients (8.9%)

Conclusion

We have diverse cohort and high percentage of consanguinity in our families of children with JIA (34.4%). Biologic treatment required in 49% of patients. Patients In remission 89.8%. Out of this 83.77% in remission on treatment and 8.9% in remission off treatment. Further studies needed to understand our population better with focus of effect of consanguinity.

References

[1] Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007 Mar 3;369(9563):767-778 [2] UAE National Bureau of Statistics. www.scad.ae. Accessed 12^th of January 2023 [3] Petty RE et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004 Feb; 31(2):390-2.

Acknowledgements

We are grateful to all the children and families for allowing us to use their data.

Disclosure of Interests

None Declared.