ABS0854 VALIDATION OF AXIAL JUVENILE SPONDYLOARTHROPATHY CRITERIA IN TURKISH JUVENILE SPONDYLOARTHROPATHY PATIENTS

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Background: Juvenile spondyloarthritis (JSpA) is in the intersection of diverse diseases including features of peripheral arthritis, axial involvement, enthesitis, acute anterior uveitis, psoriasis, inflammatory bowel disease (IBD), and HLA-B27 positivity. An international consensus group developed the axial juvenile SpA (AxJSpA) classification criteria for this purpose, defining a homogeneous group of patients diagnosed with juvenile SpA and experiencing axial symptoms before the age of 18 years. Objectives: To validate this new set of criteria in our pediatric SpA patients. Methods: This study was held in Hacettepe University Department of Pediatric Rheumatology. Juvenile SpA patients suspected of axial disease diagnosed and followed at the same center between 2005 and 2024 were included. Patients who had other etiologies for axial symptoms including chronic nonbacterial osteomyelitis, mechanical back pain- overuse injuries, amplified pain/ growing pains, and SAPHO syndrome served as control group. Results: 123 JSpA patients (36% female) and 74 controls (47% female) were included in this study. When the threshold was set at 55 as recommended, the sensitivity/specificity of the new criteria were 61%/77% with an area under curve value of 0.75 (95% CI: 0.68-0.83) in our cohort. Among different criteria sets, European Spondyloarthropathy Study Group (ESSG) criteria was the most sensitive (sensitivity/specificity 91%/68%), ASAS-peripheral criteria (Assesment in SpondyloArthritis Internaitonal Society) was the most specific (sensitivity/specificity 67%/84%) in our cohort when compared to ASAS-axial (sensitivity/specificity 74%/65%), ILAR (International League of Association for Rheumatology) (sensitivity/specificity 85%/81%) and ILAR+SI (sacroiliitis) (sensitivity/specificity 67%/74%) criteria. Conclusion: The area under the curve of the new AxJSpA criteria were similar to the original report, however, in our cohort the sensitivity and specificity were lower for various reasons. REFERENCES: [1] Rudwaleit M, Landewé R, van der Heijde D, Listing J, Brandt J, Braun J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 2009;68(6):770-6. [2] Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777-83. [3] Rudwaleit M, van der Heijde D, Landewé R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25-31. [4] Weiss PF, Brandon TG, Aggarwal A, Burgos-Vargas R, Colbert RA, Horneff G, et al. Classification Criteria for Axial Disease in Youth with Juvenile Spondyloarthritis. Arthritis Rheumatol. 2024. [5] Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34(10):1218-27. Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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