SAT0704-HPR PREVALENCE OF RHEUMATIC PATHOLOGY IN CHILDREN IN THE CENTRAL FEDERAL DISTRICT OF THE RUSSIAN FEDERATION, STRUCTURE OF MORBIDITY AND THERAPY

Abstract

Background Analysis of the incidence of rheumatic diseases in children can help to evaluate the real needs in treatment provision and improve medical service. Objectives To analyse the prevalence, structure of morbidity, and therapy of rheumatic pathology in children in the Central Federal District of the Russian Federation. Methods Statistical, sociological methods and content analysis were used. The study included generalised information on 3940 patients aged 1-17 years with various rheumatic diseases living in the 13 regions of the Central Federal District of the Russian Federation. The data is provided by the main paediatric rheumatologists of the regions. Results 5,999,124 children aged 0 to 17 years live on the territory of 13 regions of central Russia. In these regions, 3,940 patients with rheumatic diseases are observed. Our data allowed us to calculate the prevalence of rheumatic diseases per 100,000 children from 0 to 17 years. The prevalence of juvenile idiopathic arthritis (JIA) is 62.2, systemic lupus erythematosus - 0.7, juvenile dermatomyositis - 0.7, systemic scleroderma - 0.6. The overall incidence of the rheumatic disease is 65.7 per 100,000 children from 0 to 17 years. In the structure of rheumatic pathology, 94.7% are accounted for JIA, 1.1% for systemic lupus erythematosus, 1.0% for juvenile dermatomyositis, 0.9% for systemic scleroderma, 2.2% for other rheumatic diseases. 67.3% of patients receive disease-modifying anti-rheumatic drugs (DMARDs) (n = 2650), of which 80.1% receive methotrexate (n = 2122), 13.5% - sulfasalazine, 0.3% - leflunomide, 0.7% - cyclosporine A, 3.8% - corticosteroids, 0.7% - mycophenolate mofetil, 0.5% - hydroxychloroquine. Biological therapy is received by 27.5% of patients suffering from JIA (n = 1026). The data differs depending on the region. In the Bryansk region, the proportion of patients receive biological therapy is 45.8%, in the Yaroslavl region - 41.2%, in Moscow - 40.7%. More rarely, the biological therapy is initiated in Kostroma - 11.9% and Oryol - 15.3% areas. The structure of biological therapy is dominated by TNF-alpha inhibitors - 71.3%. 41.6% of all children undergoing biologic therapy were prescribed etanercept, 27.2% - adalimumab. 18.1% of patients receive tocilizumab, 7.2% - abatacept, 1% - infliximab, 2.5% - canakinumab, 1.5% of patients receive golimumab. Conclusion The overall incidence rate of rheumatic diseases in central Russian regions is 65.7 per 100,000 children from 0 to 17 years. The prevalence of juvenile idiopathic arthritis is 62.2 per 100,000 children from 0 to 17 years old. 67.3% of patients receive DMARDs. In 80.1% of cases, the drug of choice is methotrexate. 27.5% of patients suffering from JIA receive biological therapy; data vary by region (45.8% –11.9%). The structure of biological therapy is dominated by TNF–alpha inhibitors – 71.3%. At the level of various regions, countries, it is necessary to conduct research aimed at studying the causes influencing the overall incidence, the detectability of rheumatic diseases, and the structure of therapy.