AB1245 HOSPITAL ADMISSION RATES FOR JUVENILE IDIOPATHIC ARTHRITIS IN WESTERN AUSTRALIA HAVE NOT CHANGED FOLLOWING THE INTRODUCTION OF BIOLOGICAL DRUG THERAPY.

Abstract

BackgroundAggressive treatment with disease modifying drugs to reach early disease remission has become standard of care for juvenile idiopathic arthritis (JIA) in Australia this millennium (1,2).ObjectivesWe examined whether this modern approach including the availability of subsidised TNF inhibitor treatment has led to a change in the rate of first hospitalisation for JIA patients in Western Australia (WA). Hospital data were also used to estimate a minimum prevalence of JIA in WA.MethodsState-wide hospital data were used to identify patients aged 15 years and younger with a first hospitalisation for JIA between 1990 and 2012. Changes in the hospitalisation rate over time were examined using join-point regression. State-wide PBS prescription data on TNFi (available for JIA since 2004) were obtained from Services Australia and expressed as defined daily dose /1000/day (DDD).ResultsWe identified 786 unique cases of JIA in WA hospital records. At the time of the index hospitalisation, patients were on average 7.6 (± 4.4) years of age and female patients made up the majority of cases (n=465, 59.2%). The overall rate for a first hospitalization for JIA was 7.9 (95%CI: 7.3, 8.4) per 100,000 children ≤15 years, and did not change significantly over the study period (annual percentage change (APC): 1.3, 95%CI -0.3, 2.8), although TNFi usage increased linearly and DDD reached 0.3 at the end of study. The hospital-based prevalence of JIA in 2012 reached 114.5/100.000 for girls (0.12%) and 52.9/100.000 for boys (0.05%).ConclusionThe hospital based (i.e. minimum) prevalence of JIA in WA aligns with international data. Rates for a first hospitalization for JIA have not decreased during a time when early aggressive therapy became common practice and TNFi use for JIA reached 30/100.000. This unexpected finding requires further investigation.References[1]Georgina Tiller, Joanne Buckle, Roger Allen et al. Juvenile idiopathic arthritis managed in the new millennium: one year outcomes of an inception cohort of Australian children. Pediatric Rheumatology (2018) 16:69[2]Jane Munro, Emily Haesler, Jiri Rada,Amy Jasper. Juvenile idiopathic arthritis: a literature review of recent evidence. The Royal Australian College of General Practitioners, August 2009AcknowledgementsSupported by a grant from The Arthritis Foundation of Western AustraliaDisclosure of InterestsNone declared