AB0724 CANDIDATE PREDICTIVE BIOMARKERS OF POOR TREATMENT RESPONSE IN OLIGOARTICULAR ONSET JUVENILE ARTHRITIS TO EARLY STEROID INJECTIONS

Background: Intra-articular corticosteroid injections are the first-line antirheumatic drugs of oligoarticular onset juvenile arthritis. Despite significant advances in treatment (anti-TNF, block IL6) this choice pediatric chronic joint disease still remains relevant. Pediatric rheumatologists and to day there no consensus on best modality for treatment. Objectives: The aim study was search biomarkers ineffective early intra-articular steroid Methods: Clinical, imaging, laboratory data (blood synovial fluid), effect isolated (is-IAI) triamcinolone acetonide 92 children (89% girls) aged median (IQR) 4,2 (1,6 – 7,6) years with arthritis without extra-articular manifestations (oligo-JA) were collected retrospectively analyzed. All met ILAR criteria. Triamcinolone (TA) administered at a dose 20-40 mg an injection interval 3-6-12 months which depended activity disease. divided into two groups: active / inactive based effectiveness local average follow-up 48 [38; 62] months. Results: 32 (35%; all achieved remission oligo-JA after is-IAI TA mean 2 [1,75; 2] per (inactive > 24 months). between consecutive 7 [5,25; 10] Other did not achieve 3 [2; 4] joint. first 5,5 [4,25; 7] other - 3] who treated by DMARDs. Statistical analyses performed determine relationships clinical, instrumental, signs efficacy TA. Measures included number swollen or tender joints [active counts]; biological inflammatory markers [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum fluid level interleukin 6 (IL6) tumor necrosis factor alfa (TNF-α)]; autoimmunity [titer antinuclear (ANF)] physicians ’ assessment JIA [clinical Juvenile Arthritis Disease Activity Score including maximal 10 (cJADAS10)]. Efficacy associated significantly oligo-JA, cJADAS10, CRP mg/ml, ESR mm/h, IL6 pg/ml TNF-α pg/ml, titer ANF. inflamed levels 2208 [710; 4564] 3234 [1265; 16902] 3,3 [2,5; 3,8] 1,1 [0,6; 3,7] differ. analysis revealed correlation short phase beneficial risk (with less than months, OR = 2.09, p <0.001; 8.9, <0.001). Conclusion: is effective safe oligo-JA. Research that about third (all girls). There prediction poor response injections. But may be sign In addition boys considered like potentially therapy. References: [1]Kozhevnikov A.N., Pozdeeva N.A., Konev M.A., Maricheva O.N., Afonichev K.A., Novik G.A. X-ray diagnosis oligoarthritis. Bulletin Siberian Medicine . 2017; 16 (3): 224–234 DOI: 10.20538/1682-0363-2017-3-224–234 Disclosure Interests: None declared