Journal of Pediatric Care

Juvenile onset Psoriatic arthritis (jPsA) share similar clinical characteristics with adult onset Psoriatic Arthritis (PsA) but children report longer delay in diagnosis

Joint Event on 25^th World Pediatrics Conference & 6^th International Conference on Pediatric Critical Care and Emergency Medicine
October 18- 20, 2018 Warsaw, Poland

Euthalia Roussou and Maria Di Cicco

King George Hospital, United Kingdom

Posters & Accepted Abstracts: J Pediatr Care

DOI: 10.21767/2471-805X-C4-015

Abstract

To assess clinical and demographic characteristics retrospectively between those patients that had jPsA onset and those that had Psoriatic Arthritis (PsA) disease onset as adults. A registry for Spondyloarhtropathies (SpAs) aiming to assess patients’ disease progression over time (ethics approval REC: 07/H0701/74) was used as a source for the information required for analysis. A questionnaire was given to be filed in by the patients when attending the clinic. The timing was as close to the first attendance as possible (if it was not possible to be at the first attendance). The questionnaire had semi validated questions and its validation has been published before. A total of 277 patients with established PsA were asked when did the disease start. From the total of 277 there were responses enabling analysis from 220 patients (79.4%). From those 220 patients (mean age 51.14 sd 14.2 range 18-88) 13 patients (5.9%) reported age of onset below the age of 16 and classified as Juvenile onset group; 32 patients (14.5%) reported age of onset between 17 and 25 years and classified as adolescent group; 161 patients (73.1%) reported age of disease onset between 26 and 64 and classified as adult onset, while 14 patients (6.3%) reported disease onset above the age of 65. With the aim to further analyze the adult onset group we divided the group in 4 groups according to the decade of their age of disease onset. These were; 26 to 35 years old, 36 to 45, 46 to 55 and 56 to 64 years old. Patients with reported age of onset disease above the age of 65 were classified as geriatric group. From the PsA group data from the juvenile onset PsA (jPsA) (n-13) were then compared with the adult group with the age of onset 56 to 65 years (n-22) as the numbers of patients in the latter group and the gender distribution were similar to those of the jPsA group. In the total of 13 patients identified with age of disease onset of below 16 years of age, data on arthritis, enthesitis, dactylitis, axial, peripheral disease or both, HLAB27 status, disease duration, delay in diagnosis and the indices BASDAI BASFI , sleep disturbance, wellbeing over past week and treatment effect were collected . Same data collected from the adult group and comparison took place between the 2 groups. Statistical analysis was performed using the SPSS statistical program and the differences between groups were calculated using chi square t tests. The male to female distribution according to the age of onset showed that there are slightly more boys in the juvenile group (M:F = 7:6) and equal gender distribution in the 56 to 64 age group (M:F 11:11). When we looked and compared the juvenile onset PsA group with the middle age 56 to 65 adult onset group similar disease characteristics were found as per table. The treatment that the patients were in was different in that more juvenile onset patients were on biologics, and immunotherapy medication while more adults were on NSAIDs (12 patients in the adult onset group (representing 54.5%) vs 3 patients in the jPsA onset (23%) and had surgery at the time of the assessment (5 adults (22.7%) vs 1 in jPsA (7.6%) (p=0.06). However the effect of treatment was similar.

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