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  • Oral presentation
  • Open Access

A multinational study of the epidemiology, treatment and outcome of childhood arthritis (epoca study): preliminary data from 6,940 patients

  • 1,
  • 2,
  • 3,
  • 4,
  • 5,
  • 6,
  • 1, 7,
  • 1, 7 and
Pediatric Rheumatology201412 (Suppl 1) :O8

https://doi.org/10.1186/1546-0096-12-S1-O8

  • Published:

Keywords

  • Juvenile Idiopathic Arthritis
  • Uveitis
  • Biologic Medication
  • Juvenile Idiopathic Arthritis Patient
  • Pediatric Rheumatology

Introduction

The epidemiology of juvenile idiopathic arthritis (JIA) is known to be variable worldwide and the therapeutic approach to JIA is not standardized. Moreover, the availability of the novel and costly biologic medications is not uniform throughout the world, with possible significant impact on disease prognosis.

Objectives

The EPOCA study is aimed to obtain information on the frequency of JIA subtypes in different geographic areas, the therapeutic approaches adopted, and the disease status of children with JIA currently followed worldwide.

Methods

Participation in the study was proposed to the pediatric rheumatology center of all countries belonging to the Pediatric Rheumatology International Trials Organization (PRINTO), and to several centers in the US and Canada. Each centre was asked to enroll 100 consecutive JIA patients or, if less than 100, all consecutive patients seen within 6 months. Each patient received a retrospective and cross-sectional assessment. Parent- and child-reported outcomes were recorded through the administration of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Participating countries were grouped into 6 geographic areas.

Results

Currently, 6,940 patients from 41 countries have been entered in the web database. Comparison of data from the different geographic areas is presented in Table 1.

Table 1

 

Western Europe

N = 2845

Eastern Europe

N = 2171

Latin America

N = 795

Asia

N = 726

North America

N = 243

Africa

N = 79

Median onset age, yrs

4

6.3

6.6

5.9

7.5

5.7

Systemic arthritis, N (%)

202 (7.1)

165 (7.6)

143 (18)

174 (24)

16 (4.9)

11 (13.9)

Oligoarthritis, N (%)

1398 (49.1)

958 (44.1)

247 (31.1)

256 (35.3)

103 (31.8)

25 (31.6)

Enthesitis related arthritis, N (%)

253 (8.9)

248 (11.4)

74 (9.3)

92 (12.7)

35 (10.8)

3 (3.8)

Uveitis, N (%)

495 (17.4)

232 (10.7)

51 (6.4)

40 (5.5)

38 (11.7)

4 (5.1)

Median disease activity (JADAS10)

2

5

3.5

3.5

2

5

Inactive disease, N (%)

1070 (37.6)

454 (20.9)

268 (33.7)

237 (32.6)

114 (35.2)

13 (16.5)

Articular damage (JADI) > 0, N (%)

352 (12.4)

531 (24.5)

257 (32.3)

136 (18.7)

60 (18.5)

27 (34.2)

Treated with biologics, N (%)

1067 (37.5)

637 (29.3)

273 (34.3)

134 (18.5)

178 (54.9)

27 (34.2)

Conclusion

Patients seen in Western Europe have a younger age at onset and a greater prevalence of uveitis. Systemic arthritis is more common in Asian patients, whereas enthesitis related arthritis is less frequent in African patients. Children from Africa and Eastern Europe have a higher level of disease activity and a lower frequency of inactive disease, and African and Latin American patients have a greater prevalence of articular damage. Biologic medication are administered more frequently in North America and less commonly in Asia.

Disclosure of interest

None declared.

Authors’ Affiliations

(1)
Pediatria II, Istituto Giannina Gaslini, Genova, Italy
(2)
Paediatrics and Adolescent Medicine, General University Hospital, Prague, Czech Republic
(3)
Centre of Pediatrics, Vilnius University, Vilnius, Lithuania
(4)
Peadiatric Department, Odense University Hospital, Odense, Denmark
(5)
Unidad De Reumatologia Pediatrica, Hospital Universitario La Paz, Madrid, Spain
(6)
Unit of Paediatric Rheumatology, Semmelweis University, Budapest, Hungary
(7)
Pediatrics, Università di Genova, Genova, Italy

Copyright

© Consolaro et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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