Conclusion The frequency of HLAB27 was in line with the literature data. The genetic background did not influence the disease activity or the functional impairment in our population. However, a positive correla- tion was found between a positive familial history of SpA, HLAB27, and the presence of extra-articular manifestations as well as with a higher ESR value. P023 IMPACT OF JUVENILE IDIOPATHIC ARTHRITIS ON SCHOOLING AND FAMILY LIFE Sirine Miri 1 , Wafa Triki 1 , Kaouther Maatallah 1 , Hanene Ferjani 1 , Dorra Ben Nessib 1 , Dhia Kaffel 1 and Wafa Hamdi 1 1 Kassab institute Background Juvenile Idiopathic Arthritis (JIA) and its related symptoms have been associated with interference in the daily life of children and adolescents with JIA including their friendships, their school atten- dance and sometimes their family life. The aim of the study was to describe the impact of JIA on schooling, social and family life from the point of view of children. Methods We interviewed 23 children and adolescents, diagnosed with JIA according to the classification criteria of the International League of Associations for Rheumatology (ILAR). Results The mean age of our group was 16 years, with a sex ratio of 3. Eight percent of the children were in elementary school, 21.7% in high school and 8.7% in university. Eighty-seven per cent reported school absentee- ism due to JIA (pain, being hospitalized,) with a mean of 8 missed school days. Forty-three per cent failed in their schooling at some point. Thirty percent thought it was related to the consequences of their disease. Only 47.8% found the school staff to be helpful and supportive. Seventy eight percent felt understood and supported by their family in dealing with the different aspects of JIA. Twenty-six per cent felt more spoiled than their other siblings, creating tension sometimes. Fifty two percent felt different and not accepted by their peers because of the JIA. Conclusions Children with JIA are already suffering from the physical aspect of their disease. Initiating an open discussion with them might reduce the burden these children are carrying often in silence, and improve long- term outcomes in terms of schooling, social and, family life. P024 EFFICACY AND TOLERANCE OF METHOTREXATE IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS A. Fazaa 1,2 , F. Rouatbi 1,2 , S. Miladi 1,2 , K. Ouenniche 1 , L. Souabni 1 , S. Kassab 1 , S. Chekili 1 , K. Ben Abdelghani 1,2 and A. Laatar 1,2 1 Rheumatology Department, Mongi Slim Hospital, Kassab Institute,La Marsa, Tunisia 2 Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia Background Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease for children. The therapeutic management depends on several factors and is based on different treatments including methotrexate (MTX). The aim of our study was to determine the efficacy and safety of MTX in JIA. Methods This is a monocentric retrospective study of 37 patients followed for JIA according to the 2001 International League of Association of Rheumatology (ILAR) criteria and treated with MTX. Socio-demo- graphic, clinical, paraclinical and therapeutic data were collected. Disease activity was assessed by the JADAS score. Highly active JIA was defined as JADAS superior to 25. Results There were 25 boys (67.5%) and 12 girls (32.4%) with a median age of 6.3 years [4–13]. The average duration of the rheumatic disease was 2.7 years [2.5–5.3]. The type of JIA was: oligoarticular in 22 cases (59.4%), polyarticular in 10 cases (27%), arthritis related to enthesitis in 3 cases (8.1%) and systemic in 2 cases (5.4%). Twenty patients (54%) received oral corticosteroid therapy for a mean period of 1.7 years [0.6–3] with a mean daily dose of 10 mg/day of prednisone or equivalent. Oral MTX was prescribed to all patients with a mean weekly dose of 10 mg/m2 body surface [10–15]. MTX was initiated after a mean period of 6.2 months [3.1–11.4] from diagnosis. The mean treatment duration was 50 months [34–66]. Observance of MTX was 80.5%. Remission with MTX was achieved in 28 patients (75.6%) after a mean treatment duration of 7.5 months [5– 11], with a mean JADAS of 5.1 [3.5–10]. Despite good observance of MTX, eight patients (21.6%) continued to have high disease activity with a mean JADAS score of 32 [25–40]. Tolerance to oral MTX was good, with side effects occurring only with 5 patients (13.5%), such as epigastralgia in 2 cases (which disappeared after switching to the intramuscular administration), a skin reaction in one case, and hepatic cytolysis reversible when stopping the treatment in 2 other cases. Conclusion MTX still has a place in the therapeutic management of JIA and appears to be a well-tolerated and effective treatment. P025 RISK ASSESSMENT OF COVID 19 IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS Cherif Ines, Dorra Ben Nessib, Kaouther Maatallah, Hanene Ferjani, Wafa Triki, Dhia Kaffel and Wafa Hamdi 1 Rheumatology Department, Kassab Orthopedics Institute, Mannouba, Tunisia, 2 Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia Background On March 11th, 2020 the World Health Organization declared the coronavirus outbreak a global pandemic. Since then, the world has faced multiple flares. In March 2021, the third wave hit Tunisia, resulting in a total of 331 674 confirmed cases and 12 089 Covid-19 related deaths (on May 19th, 2021). Among these reported cases, >6000 were children under the age of 18. Patients with inflammatory rheumatic diseases undergoing immunosup- pressive treatment are considered immunocompromised. Therefore, it is only fair to question whether children suffering from juvenile idiopathic arthritis (JIA) are specially at risk during this pandemic. Our objective was to assess the impact of the Covid -19 pandemic on patients with JIA. Methods We conducted a cross-sectional study including patients with JIA, all fulfilling the International League of Associations for Rheumatology (ILAR) criteria. We prepared a questionnaire evaluating the clinical data of our patients during the outbreak. We asked whether the child had been infected with the virus or whether he had contact histories with confirmed cases, and if so, had the child developed any symptoms (such as fever, respiratory, digestive or osteoarticular symptoms, myalgia, asthenia) or required any specific care. For all patients, we collected the following data: age, age of onset, the duration of the disease, JIA subtype, and the current treatment. Results We included 25 JIA patients, mean age at disease onset was 7.6 þ/- 3.8 years [1–11]. Among them, 17 were female. The mean duration of the disease was 4.9 þ/- 3 years [0–15]. Three patients were on biological disease-modifying anti-rheumatic drugs (bDMARDs) and six on conventional synthetic DMARDs (csDMARDs). Sixteen patients had no background treatment. None of the children had a positive PCR test nor symptoms suggestive of Covid-19. There were only 2 children with contact histories with confirmed cases: one with his cousin and one with his grandfather. Both patients were on NSAIDS with no DMARDS, and both followed social distancing rules. Neither one of them developed any symptoms. There have been no reports of absenteeism from school or medical checkups or disruption of treatment due to this pandemic, outside of the government-imposed lockdown period. Conclusion None of our patients contracted the corona virus or developed any symptoms, during the deadliest wave in Tunisia to date. These results align with different research and the hypothesis that children with JIA under treatment do not have an increased susceptibility to COVID-19 compared with healthy children. Our study, however, had its limitations due to the small number of patients. Further research with larger sample size are, therefore, required. P026 EFFICACY AND SAFETY OF ETANERCEPT FOR THE TREATMENT OF JUVENILE IDIOPATHIC ARTHRITIS EXPERIENCE OF THE PEDIATRIC CENTER IN SETIF— ALGERIA Kamelia Okka 1 , M. Belghazi 1 , A. Dehimi 1 , Z. Benarab 1 , S. Bouabdallah 1 and B. Bioud 1 1 Pediatric Center, Setif, Algeria Background Etanercept (ETN) is the first anti-TNF to have obtained FDA approval in 1999 for juvenile idiopathic arthritis (JIA) refractory to methotrexate. Currently, the indications of ETN cover the polyarticular JIA, the E POSTERS v9 Downloaded from https://academic.oup.com/rheumatology/article/60/Supplement_5/keab722.018/6425181 by guest on 22 August 2023