BIOLOGIC THERAPY IN JUVENILE IDIOPATHIC ARTHRITIS TUNISIAN PATIENTS

M. Ardhaoui, D. Khalifa, O. Farhat, R. Fakhfakh, N. El Amri, K. Baccouche, E. BouajinaFarhat Hached Hospital, Rheumatology, Sousse, Tunisia  Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children under the age of 16. Biologic therapy significantly improved the management and prognosis of this disease. Objectives We aimed to evaluate the indications, clinical efficacy and safety of biotherapy for the treatment of JIA in a tunisian population. Methods This is a monocentric retrospective and observational study including patients followed for JIA (ILAR criteria) in the Rheumatology department of Sousse in Tunisia. Results Fifty-five children (28 girls and 27 boys) were included. The mean age was 13.6 years. The predominant subtypes of JIA were the seronegative polyarticular JIA (38.2%), and the seronegative oligoarticular form and juvenile spondyloarthritis (16.4% each). Besides biologics, our patients received non steroidal anti-inflammatory drugs (61.8%), oral corticosteroids (67.3%), and pulse steroid therapy in 47.3% of cases. Methotrexate was used for 65.5% of patients. Twenty-four patients were treated with biologics, with a prevalence of 41.8%. The mean age at the beginning of biotherapy was 12 years, with a mean time for initiation of 5 years. The main indications were the first and second-line treatments failure (29.1%) and their side effects (12.7%). The most frequently used biologics were TNF alpha blockers: Etanercept (9 patients), Infliximab (6 patients), Certolizumab and Adalimumab (2 patients each). Anti-Interleukin-6 (Tocilizumab) was used in the systemic JIA form for 4 patients. The mean duration of treatment with biologics was 3.55 years. A trend towards lower disease activity was observed with steroid therapy stopped in 25%. Five patients switched biologics. The overall safety profile was good. No serious adverse drug events occurred except anaphylaxis in 2 cases: 1 with Tocilizumab and one with Infliximab. The other side effects were hepatic toxicity with elevated transaminases (2 patients) and moderate cutaneous infection (1 patient). Conclusion Biologics have provided interesting new therapeutic alternatives in Tunisian patients with JIA, despite the delay of their initiation. However, the long-term side effects of modulating the immune system are not yet fully understood in this young population. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared. Keywords: bDMARD, Inflammatory arthritides DOI: 10.1136/annrheumdis-2023-eular.4777Citation: , volume 82, supplement 1, year 2023, page 1946Session: Paediatric rheumatology (Publication only)