AB1093 Can dmards therapy modify clinical history of oligoarticular juvenile idiopathic arthritis (JIA)?. (12th June 2018)

• Record Type: Journal Article
• Authors: Bertoldo, E.; Mansoldo, C.; Martinis, F.; Dallagiacoma, G.; Biasi, D.; Rossini, M.; Pieropan, S.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1656
• Page End: 1656
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2612
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Therapy of oligoarticular JIA is based on intrarticular injections of steroids, methotrexate and biotechnological therapy. ANAs-positive oligoarticular JIA patients with an early onset of disease have a consistent risk to develop uveites. Objectives: The primary aim of this study is to evaluate longitudinally the effect of non-systemic therapy and of systemic immmunomodulating drugs (e.g MTX) on ANAs in JIA patients; secondary occurance of iridocyclitis was evaluated. Methods: Monocentric retrospective not randomised study of 40 patients affected by oligoarticular JIA (ILAR classification) with ANA positivity at the baseline (T0, time of diagnosis). Patient of Group 1 received only intra-articular infiltrations or NSAID. Patients of Group 2 were treated with DMARDs (most of them with subcutaneous MTX 15 mg/m2/week) or MTX +biotechnlogical therapies. The assay for ANAs (I.I.F.) was assessed in all patients at T0, at T1 (12 months) and T2 (24 months). At 24 months was also recorded the occurence of uveitis during the follow up. Exclusion criteria were the ANAs negativity at T0 and other subgroups of JIA. Results: Twenty-one patients (52, 5%) were treated with non-systemic therapy (Group 1), and ninenteen (47, 5%) with systemic immunomodulating therapy (Group 2). In Group 2 fifteen subjects were treated with MTX, one with MTX plus cyclosporine, one with only cyclosporine, two with MTX plus biotechnological agent (etarnecept and adalimumab). At T1, in Group 1 only one patient out of 20 (4, 8%) became ANAs negative versus 42, 1% (8/19) of patients in Group 2 (p 0.0033). At T2 the incidence of ANAs positivity did not change in Group 1 (only 1/21 ANAs negative), while 42, 1% of patients treated with systemic therapies were ANA negative (p 0.006). Three patients were lost at the follow up. The two patients who received bDMARDs in addition to MTX remained ANAs-positive both in T1 and T2. At the end of follow-up period eight uveitis have occured, six in ANAs positive patients of Group 1 (6/21, 28, 5%) and two in ANA negatives patients in Group 2 (2/19, 10, 5%). Conclusions: ANAs-positive patients treated with methotrexate seems to have higher possibility to became ANAs-negative versus patients treated with non-systemic immunomodulating therapy. It's known that MTX might prevent onset of uveitis in JIA, as shown in our results. Demostrating a negativization of antinuclear antibodies using MTX therapy could help to add a role of this drug in the disease history of the oligoarthritis. Disclosure of Interest: None declared