THU0513 MEDICATION BURDEN IN YOUNG ADULTS WITH JUVENILE IDIOPATHIC ARTHRITIS – RESULTS OF AN OBSERVATIONAL COHORT STUDY

Background: Juvenile idiopathic arthritis (JIA) often persists into adulthood, and many young adults with JIA still need antirheumatic medication. Rheumatologists prescribe DMARDs and glucocorticoids, but are not always aware of other medications taken by patients concurrently. Self-reported medication use was used to obtain information on drug exposure of young adults with JIA. Objectives: To evaluate medication use in a large cohort of young adults with JIA ever treated with DMARDs. Methods: Patients ever treated with DMARDs and prospectively observed in the JIA biologic registry JuMBO were asked about their drug consumption at each JuMBO visit. In addition, patients reported their current health status in terms of disease activity and pain (scored on numerical rating scales 0-10), functional ability (by HAQ) and quality of life (by SF-36). The Anatomical Therapeutic Chemical Classification System for medicinal products (ATC) was used to classify self-reported medication use. Local therapies, with the exception of ophthalmological drugs, and cough and cold remedies were not included. Results: A total of 1,306 young adults (68% female) with JIA and a mean disease duration of 13.6±6 years (ys) were included in the analysis. The majority of them were classified as polyarticular-onset JIA (35.6%), 20.5% as enthesitis-related arthritis. At the last follow-up (FU), the patients´ mean age was 23.1±4.1 ys. They had received a mean of 2.6±1.4 DMARDs, 79% were ever treated with biologics. At FU, patients used on average 1.9±1.8 drugs. About one in five patients (296, 22.7%) reported no medication use at all, 367 (28.1%) reported only DMARD use. The most frequently reported drugs were DMARDs (64%), NSAIDs (48%), glucocorticoids (19%), followed by analgesics (10.6%), drugs for acid-related disorders (6.9%) and anti-infectives for systemic use (6.1%). Antidepressant drug use reported 3.4% and antihypertensive drug use 3.1% of the patients. Women used significantly more frequently NSAIDs, glucocorticoids, non-opioid analgesics and thyroid medication. There were 178 (14%) patients who received at least 3 other medications in addition to DMARDs. This patient group frequently reported the use of pain medication (74% NSAIDs, 23% non-opioid analgesics, 20% opioid drugs) and antidepressants (16%) and had been treated late with bDMARDs (7.4±4.9 ys after symptom onset). There were significant differences in drug usage between patients with various JIA categories (table). Moreover, the use of glucocorticoids, antihypertensives and antidepressants in adulthood (adjusted by propensity scores) increased with longer time from symptom onset to bDMARD start. Conclusion: Self-reported medication use adds important information when assessing the long-term outcome of JIA. About 15% of JIA patients ever exposed to DMARDs, especially those with late start of bDMARD therapy, have a high medication or disease burden in young adulthood. Acknowledgments: JUMBO - joint unconditional grant from Pfizer, Abbvie, Roche Disclosure of Interests: Laura Montag: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Stefanie Tatsis: None declared, Eva Seipelt: None declared, Paula Hoff Consultant of: BMS, Amgen, Speakers bureau: Novartis, Jansen, Pfizer, Mylan, BMS, Gerd Horneff Grant/research support from: AbbVie, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Speakers bureau: AbbVie, Bayer, Chugai, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Kirsten Minden Consultant of: GlaxoSmithKline, Sanofi, Speakers bureau: Roche