AB0861 Prognostic Value of Ana Positivity in Greek Adult JIA Patients

BackgroundAntinuclear antibodies (ANA), one of the biomarkers of ILAR JIA classification, has been proposed to be associated with a protracted disease course overtime, regardless of JIA subtype. However, their role in the disease outcome is still debated.ObjectivesTo investigate the impact of ANA positivity in the long-term outcome of JIA patients.MethodsPatients ≥18 years with an established JIA, a minimal disease duration of 5 years and no history of a >6–month care from external rheumatologists, were enrolled in the study. Data were retrieved from the patients' charts, including ANA titers at onset (2 measurements, 3 months apart). The ANA were measured by indirect immunofluorescence (cut-off value ≥1:160). Clinical, laboratory -including ANA- and radiographic assessment were performed at the last follow-up visit, 17.2 years post-diagnosis. The outcome variables defined were: radiographic damage assessed by the total modified Sharp/van der Heijde Score (TmSvdHS), articular and extra-articular damage by Juvenile Arthritis Damage Index (JADI-A and JADI-E), physical ability by the Health Assessment Questionnaire-Disability Index (HAQ-DI) and the cumulative % times spent in a state of disease activity and of clinical remission off medication (CR).ResultsHundred two patients (72 females) were enrolled. The disease age of onset (mean ±SD) was 7.7±4 years, the interval from onset to last visit 17.2±6.7 years and the patients' current age 25±5.9 years. Thirty three (32.4%) patients were ANA positive at onset. At the last follow-up, there was no significant difference between ANA positive and ANA negative patients in terms of TmSvdHS (p=0.982), JADI-A (p=0.699), JADI-E (p=0.235), HAQ-DI (p=0.234), cumulative % time spent in disease activity (p=0.583) or CR (p=0.175). There was no statistical gender difference among ANA positive patients (F:M 36.6%:25%, p=0.385), but they had an earlier disease onset (p=0.038), mostly oligoarticular (p=0.004) and were more prone to uveitis development (p=0.001). In the multivariate analysis ANA positivity was found to be the single independent risk factor for uveitis development [OR (95%) 10.703 (1.821, 62.899), p=0.009].ConclusionsPatients with ANA positive had predominantly an earlier and oligoarticular disease onset and a higher risk of uveitis development. However, ANA positivity was not found to influence the final disease outcome in terms of articular and extra articular degree of damage, radiographic abnormalities, physica