453 Determining the effectiveness of systemic immunomodulatory therapy in the treatment of patients with juvenile idiopathic arthritis associated uveitis depending on the chosen outcome measures

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Indroduction The number of patients with juvenile idiopathic arthritis associated uveitis (JIA-U) who require systemic immunomodulatory treatment (IMT) for disease control is small. Variabilities in the patient selection and the results on the effectiveness of IMT make it difficult to compare studies. We aimed to show the difference between obtained levels of therapy efficacy on the same sample of JIA-U patients depending on the selected outcomes. Methods The longitudinal observational study with JIA-U patients treated with IMT was conducted at University Hospital Centre Zagreb in the period from 2011 to 2017. We included 38 JIA-U patients aged 2 to 15 years and 69 eyes (7 patients had unilateral JIA-U). Results At baseline 46 (66.7%) eyes had grade ≤1+ of nflammation in anterior chamber (AC) according to Standardization of Uveitis Nomenclature (SUN) Working Group criteria, 11 (15.9%) had grade 2+, 3 (4.4%) had grade 3+. 23 children (60.5%) had already received methotrexate (MTX), 8 (21.0%) biologics, 4 (10.5%) systemic glucocorticoids (GC). Topical glucocorticoids (TGC) in the form of drops were used in 61 (88.4%) eyes with a median of 4 daily doses, GC ointment in 75.4% of the eyes with a median of 1 dose. Until the end of the follow-up, all children received MTX, and 40% of them biologics. The results of the effectiveness of IMT are presented according to the reduction of the need for TGC and achieved level of inflammation in AC. In the first 12 months, among JIA-U patients treated with both biologics and MTX, in 65% of eyes there was no need for TGC therapy, in the 48th month in 50% of eyes, while the rest required 1-2 daily doses of TGC. At the end of the first year, with MTX and biological therapy 75% of eyes had grade 0 of inflammation and in 48th month 61.1%. In the 12th month in 75% of eyes a grade 0 of inflammation was achieved with ≤2 doses of TGC, and in the 48th month in 61.1%. According to milder criteria, in the 12th month 90% of the eyes have a degree of inflammation ≤0,5+ with ≤2 doses of TGC, and in the 48th month all patients achieved this goal. Conclusion It was shown that the results of treatment outcomes during follow-up largely depend on the selected outcome measures. This will be important for future research because setting different limits can lead to a more favorable outcome.

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