P087 Predictors of long-term functional outcomes of juvenile idiopathic arthritis-enthesitis-related arthritis: a single-centre experience

Abstract

Background/Aims Long-term functional outcomes in enthesitis-related arthritis (ERA), is limited from developing countries. We assessed the clinical and genetic factors that predicted the long-term functional outcome in ERA. Methods Patients with ERA having >5 years of disease and > 16 years of age were included in this cross-sectional study. Data on clinical features within 6 months of disease onset was collected from hospital records. Bath indices, HAQ-DI, and WHO-QOL were assessed at last visit. Poor functional outcome (PFO) was defined as BASFI>1.5 or HAQ-DI>1. Persistent disease activity (PDA) was defined as BASDAI>4. ERAP-1 and IL23R SNP genotyping was done by TaqMan method and HLA-B27 by PCR. Results 181 patients [170-male, age of disease onset 12.5 (10-15) years, disease duration 7 (5-11) years] were recruited. There was delay in diagnosis of 3 (1-5) years. The median ASDAS-ESR, BASDAI, HAQ-DI, and BASFI at inclusion were 2.6 (1.8-3.6), 2.6 (1-5.2), 0.5 (0-0.5) and 1.6 (0.3-3.2) respectively. BASFI and HAQ-DI correlated with ASDAS-ESR, ASDAS-CRP and WHO-QOL-BREF. Those with PFO (n = 98) had a longer delay in diagnosis (4 vs 2 years, p < 0.001), lower prevalence of arthritis at onset (OR = 0.3, 95%CI:0.1-0.8), higher prevalence of ERAP1(rs27044) allele C (OR = 7.2, 95%CI:1.5-33.7), and higher disease activity currently. Delay in diagnosis (OR = 1.2; 95%CI:1.08-1.4) was the sole predictors of PFO in multivariate analysis. One-third of patients had PDA. Tarsitis at disease onset was the sole predictor of PDA (OR = 2.3; 95%CI:1.009-5.4). Conclusion Poor functional outcome was seen in one-half of JIA-ERA in the long-term and was associated with active disease with delay in diagnosis as its sole predictor. Disclosure N. Ravichandran: None. S. Guleria: None. N. Mohindra: None. A. Aggarwal: None.