Evaluation of ilar and printo classifcations for juvenile idiopathic arthritis: oligoarticular JIA vs early-onset ANA positive JIA

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Küçükali B., Yıldız Yıldırım Ç., Gülle B. T., Gezgin Yıldırım D., Bakkaloğlu Ezgü S. A.

31st European Paediatric Rheumatology Congress, Gothenburg, İsveç, 11 - 14 Eylül 2024, ss.12

  • Yayın Türü: Bildiri / Özet Bildiri
  • Doi Numarası: 10.1186/s12969-024-01005-y
  • Basıldığı Şehir: Gothenburg
  • Basıldığı Ülke: İsveç
  • Sayfa Sayıları: ss.12
  • Gazi Üniversitesi Adresli: Evet

Özet

Introduction: International League of Associations for Rheumatology (ILAR) juvenile idiopathic arthritis (JIA) classifcation revisited by Pediatric Rheumatology International Trials Organization (PRINTO) in 2018. Classifcations should provide uniform groups to assist physicians to provide optimal care. Objectives: We evaluated changes proposed by PRINTO to highlight their impact on forming consistent groups regarding uveitis and treatment responses, particularly focusing on early-onset anti-nuclear antibody (ANA) positive JIA.

Methods: Pediatric patients diagnosed with JIA according to ILAR and PRINTO classifcation, with a minimum one-year follow-up, were enrolled, excluding those meeting both oligoarticular JIA and earlyonset ANA positive JIA groups’ exclusion criteria.

Results: Among 139 enrolled patients, 110 (79.1%) had oligoarticular JIA, while 15 (10.8%) had early-onset ANA-positive JIA. Below age 5 criteria showed the strongest association with uveitis, while below age 7 provided similar associations without substantial exclusions (Odds ratio 8.62 [2.50-29.81] vs 7.45 [2.37-26.66]). Patients with single ANA positivity at a titer ≥ 1/160 and below age 7 had a notably higher risk of new-onset uveitis and biologic DMARDs requirement (Odds ratio 7.95 [2.37-26.66] and 3.6 [1.42-9.09], respectively).

Conclusion: Inclusion of age of disease onset and ANA positivity with a titer ≥ 1/160 has enhanced uniformity in uveitis risk and treatment response, including conventional synthetic DMARDs failure. A single ANA positivity at a ≥ 1/160 titer yields similar or better results, while the involved joint count criteria failed to form consistent groups. PRINTO’s classifcation places a signifcant portion of patients into the “other JIA” group, necessitating further classifcation for improved clinical utility. Date of birth:: mar