Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data

Age-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL.

Coronary artery lesions in Takayasu arteritis

Introduction

Takayasu arteritis (TAK) is a granulomatous inflammation of vessels of large diameter, mainly affecting the aorta and its proximal branches, which is more common in young women. The incidence of coronary artery disease in TAK is unknown and not sufficiently studied.

Material and methods

A literature review was performed for the period 2003 to 2023 using a search of the PubMed and Scopus scientific databases. We used the following key words to search the academic journal databases: "Takayasu arteritis", "coronary angiography", "myocardial revascularization", "coronary artery disease", "angina pectoris", and "myocardial infarction".

Results

The analysis of studies showed that coronary artery lesions (CAL) in TAK are not uncommon, being identified particularly in children and young individuals. Pathology of the coronary arteries increases the morbidity and mortality of TAK patients. In TAK, the ostia and proximal segments of the coronary arteries are more frequently affected, presenting as stenosis or occlusion with the development of stable coronary artery disease, unstable coronary artery disease, acute myocardial infarction, and sudden death. The diagnosis of TAK and coronary artery pathology is often complicated due to nonspecific manifestations and frequently the absence of symptoms. The treatment of patients with TAK with CAL is challenging and requires both pharmacological therapy and interventional or surgical methods of myocardial revascularization.

Conclusions

Takayasu arteritis is a more prevalent cause of CAL development, especially in young patients, than previously believed, and cardiovascular death due to CAL is not rare. Early diagnosis of TAK with CAL, particularly occlusion or hemodynamically significant stenosis, and the prompt initiation of appropriate treatment prevent dangerous complications, reduce mortality, and improve prognosis.

Impact of Ukrainian- Russian War on Health Care and Humanitarian Crisis

Authors explore the influence of Russian aggression on Ukrainian health care and humanitarian crises. On February 24, 2022, Ukraine faced an unprovoked brutal Russian invasion resulting in multiple negative consequences. During the 3 mo of full-scale war, Russians damaged more than 600 hospitals and killed at least 12 medics. Access to health care is severely impacted due to security concerns, restricted mobility, broken supply chains, and mass population displacement. Health care continues to come under attack (including attacks against health facilities, transport, personnel, patients, supplies, and warehouses), with a total of 295 attacks on health care, resulting in 59 injuries and 76 deaths, reported between February 24 and June 15. Ministry of Health reported that 1658 medical workers had been forced to change their residence and became employed in other regions of the country. Russian aggression negatively influenced not only the medical system and economics, but it led to a humanitarian crisis in the whole of Ukraine.

POS1315 PREVALENCE OF SARCOPENIA IN YOUNG ADULTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Background

In the 2019 sarcopenia consensus update (EWGSOP2 [1]) experts emphasize low muscle strength as a key characteristic of sarcopenia, adding low muscle mass to confirm the diagnosis of sarcopenia. Thus, the presence of the first criterion indicates probable sarcopenia, the presence of the first and second criteria confirms the diagnosis of sarcopenia, and the presence of all three criteria indicates severe sarcopenia. There are no available data about severe sarcopenia in young adults with juvenile idiopathic arthritis (JIA).

Objectives

This study aims to assess the prevalence of severe sarcopenia in young patients with JIA.

Methods

To confirm the diagnosis of severe sarcopenia we used dual X-ray absorptiometry (DXA) to assess low muscle mass (cut off points for ASM/height2 <7 kg/m2 for men and <5,67 kg/m2 for women); dynamometry - to determine the low muscle strength (grip strength <27 kg for men, <16 kg for women); gait speed and short physical performance battery (SPPB) to assess physical function (cut off points <8 m/sec and score ≤8, respectively). Patients were divided into two groups according to the presence or absence of all three criteria for severe sarcopenia.

Results

We studied 40 young adults with JIA, including 23 female patients and 17 male patients. The mean age of the patients was 24,4±5 years; the mean age at the onset of the disease was 10,1±4,4 years. Patients were divided into 2 groups according to all three criteria for severe sarcopenia. The first group (I group) included 25 patients with reduced muscle mass, strength, and physical function, and the second group (II group) included 15 patients without criteria of severe sarcopenia. In the I and the II groups mean ASM/height2 was 5,1±0,8 kg/m2 vs 7,7±1,01 kg/m2; p=0,01; handgrip strength 14,8 ±4,8 kg vs 27,1±8,3 kg; p=0,01; gait speed 0,6±0,1 m/sec vs 1,4±0,6 m/sec; p=0,01; SPPB score 6,5±1,5 vs 10,9±1,3; p=0,01. The research found out: the height and weight of patients in the group with severe sarcopenia were lower than in the group without severe sarcopenia (height 1,67±0,07 m vs 1,75±0,08 m; p=0,01; weight 56,1±9,2 kg, 72,0±12,8 kg; p=0,01, respectively). The age of patients was not significantly different between the two groups, but the duration of the disease was longer in the I group 16,4±8,2 vs 9,2±5,3; p=0,01. The data of DXA differed between groups: the patients of I group had statistically reduced total BMD 1,07±0,1 g/cm2 vs 1,15±0,14 g/cm2; ultra-distal radius BMD 0,35±0,1 g/cm2 vs 0,51±0,12 g/cm2; femoral neck BMD 0,85±0,1 g/cm2 vs 1,04±0,2 g/cm2; p=0,01, respectively. Comparing the two groups, we found important differences: the level of ESR was higher in the I group 25,05±18,3 vs 11,5±10,02; p=0,01; the index of disease activity either (DAS28 4,0±1,5 vs 2,7±1,2; JADAS27 15,8±9,2 vs 8,3±4,8; p=0,01, respectively). Articular and extraarticular damage index were higher in I group: JADI-A 5,08±7,3 vs 0,5±0,7; p =0,01; JADI-E 1,7±1,8 vs 0,3±0,6, p=0,02.

Conclusion

The study confirms the presence of severe sarcopenia despite the young age of patients with JIA. Severe sarcopenia occurs in patients with a higher level of inflammatory activity, articular and extraarticular damage, reduced bone mineral density, and longer duration of the disease. Further study of the factors influencing the development of sarcopenia in this category of young patients is required.

References

[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis [published correction appears in Age Ageing. 2019 Jul 1;48(4):601]. Age Ageing. 2019;48(1):16-31

Disclosure of Interests

None declared

AB0746 THE ASSOCIATION BETWEEN PRESARCOPENIA AND BONE MINERAL DENSITY IN ADULT PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Background:

The importance of presarcopenia (low lean mass) in clinical practice is accompanied by a high risk of adverse effects such as early disability, reduced quality of life, and increased mortality.

Objectives:

The aim of the study was to assess the link between bone mineral density (BMD) and the state of the muscular system in adult patients with juvenile idiopathic arthritis (JIA).

Methods:

The study was performed in Oleksandrivska Clinical Hospital of Kyiv, Ukraine, where adult patients were transferred from pediatric rheumatologists. Inclusion criteria: patients aged 18-44 years at the time of signing the informed consent; diagnosis of JIA in childhood, verified according to ILAR criteria, duration of JIA >3 years. According to the European Working Group on Sarcopenia in the Elderly (EWGSOP) 2019, patients with a decrease in muscle mass alone were diagnosed with presarcopenia. The BMD and muscle tissue were determined in standard localizations using dual X-ray absorptiometry (DXA).

Results:

The study included 26 adult patients with JIA, including 10 male patients and 16 female patients. The mean age at the time of examination was 22.3 ± 8.15 years; the mean age at the onset of the disease was 9.04 ± 4.9 years. According to the ILAR classification, patients had the following variants of JIA: 3 patients with RF-negative polyarticular variant, 8 patients with persistent oligoarthritis, 4 patients with extended oligoarthritis, 6 patients with RF-positive polyarthritis variant, and 5 patients with systemic JIA. According to the EWGSOP, 2019 reduced muscle mass was calculated by skeletal muscle index (SMI); the cut-off points were considered by SMI <7 kg/m2 for male, <6 kg/m2 for female. Patients were divided into two groups depending on the presence or absence of presarcopenia. The first group (1-st group) included 16 patients with reduced muscle mass (SMI – 5,22± 0,72 kg/m2), and the second group (2-nd group) included 10 patients without reduced muscle mass (SMI – 8,05± 0,94 kg/m2). It was found that the height and weight of patients in the group of presarcopenia was lower than in the group without a low lean mass (height 1,6±0,07 m vs 1,7±0,09 m, t=-2,53; p=0,01; weight 55,06±8,3 kg, 70,0±10,8 kg, t=-3,9; p=0,0007, respectively). The age of patients (25,3±10,1 and 21,3±5,9 years for 1-st and 2-nd groups respectively) and the duration of the disease (17,1±9,5 and 10,3±6,1 for 1-st and 2-nd groups respectively) did not differ statistically between the groups. The age of the onset of JIA in both groups also did not differ (7,8±4,5 and 11,5±4,1 for the 1-st and 2-nd group respectively). The following data were obtained by DXA. The patients of 1-st group had statistically reduced BMD in the region of femoral neck - 0,927±0,15 g/cm2 vs 1,179±0,13 g/cm2, t=-3,18; p=0,006; total hip - 0,977±0,16 g/cm2 vs 1,184±0,05 g/cm2, t=-3,05, p=0,0080; total body - 1,080±0,1 g/cm2 vs 1,193±0,15 g/cm2, t=-2,19; p=0,03; and ultra-distal radius - 0,286±0,06 g/cm2 vs 0,482±0,11 g/cm2, t=-3,60; p=0,007. The BMD in the region of lumbar spine did not differ in two groups - 1,152±0,16 g/cm2 vs 1,137±0,17 g/cm2, t=0,21; p=0,8. In the group of presarcopenia there was a visible decrease in the level of the metabolite of vitamin 25(OH)D3, but not statistically significant: 15,5±7,3 nmol/l vs 19,7±8,6 nmol/l, t =1,0; p=0,3. The study has strengths such as first described presarcopenia in young adults with JIA and potential limitations such as mono-center study and a small number of patients.

Conclusion:

The BMD in the region of total hip, femoral neck, ultra-distal radius, and total body in patients with decreased muscle mass was significantly lower than in patients without low lean mass.

References:

[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis [published correction appears in Age Ageing. 2019 Jul 1;48(4):601]. Age Ageing. 2019;48(1):16-31

Disclosure of Interests:

None declared

The Emerging Challenge of Pain in Systemic Sclerosis: Similarity to the Pain Experience Reported by Sjőgren's Syndrome Patients

In order to evaluate the importance of pain in systemic sclerosis (SSc), the characteristics of pain reported by patients with SSc were analyzed and compared with the characteristics of pain reported by patients with primary Sjőgren's syndrome (pSS). Pain was reported by 56 patients (80%) in a group of 70 patients with SSc and by 25 patients (78%) in a group of 32 patients with pSS. Pain severity was assessed by the Pain Rating Index (PRI) and the Present Pain Intensity (PPI) of the McGill Pain Questionnaire (MPQ) and by values obtained by a visual analog scale (VAS) indicating the intensity of pain felt in the moment of the examination and the intensity of pain felt in the week preceding the moment of the examination. No significant difference was detected in the comparison of mean values of pain indices between patients with SSc and patients with pSS and in the comparison among subgroups of patients with SSc. The data indicate that pain is a frequent and important cause of suffering in SSc as in other chronic diseases. The association of different methods may be especially useful to obtain a careful evaluation of pain in clinical research.

FRI0492 СLINICAL AND LABORATORY DATA AND ALGORITHM OF MANAGEMENT OF ADULT PATIENTS WITH OLIGO-ARTICULAR VARIANTS OF JIA

Background:

The oligo-articular JIA is a disease that begins in childhood and can lead to joint damage and disability in adulthood with significant social losses.

Objectives:

The aim of this study was to evaluate the clinical and laboratory status and to develop an algorithm of managment adult patients with oligo articular variant of JIA, depending on the detection of RF or/and A-CCP, ANA, HLA-B27.

Methods:

The study included 168 adult patients from different regions of Ukraine who were diagnosed with JIA in childhood between 1984 and 2014 without severe comorbidities. Inclusion criteria were: age 16 to 60 years; duration of the disease > 3 years. Among patients with JIA were identified 64 patients with oligo-articular variant: 44 (26,2%) - with persistant oligo-arthritis, and 20 (11,9%) with extended oligo-arthritis. The disease activity was evaluated by DAS28 and JADAS-10. The questionaries SF-36, HAQ, TAS-20, PHQ-9 were analyzed and remote articular JADI-A and extra-articular JADI-E damages were evaluated. Statistical studies were performed using IBM SPPS Statistics version 25.0.0.0 software, the results were considered to be reliable at 5% critical level (P <0.05). The distribution of quantitative variables was tested by the Shapiro-Wilk test. Quantitative variables with a normal distribution were expressed as mean ± SD, quantitative variables that showed a non-normal distribution were expressed with a median (P25-P75), also performed correlative analysis of the variables

Results:

It was found that patients with active JIA in 26.5% have depression according to the PHQ-9, while patients in remission have no signs of depression. Most adult patients with JIA (86.4%) have elevated and high levels of alexithymia. The predictors of JIA remission in adulthood are male sex (OR = 0.453; 95% CI 0.253-3.556); arthritis of more than 3 joints (OR = 0.459; 95% CI 0.347-0.770); wrist arthritis in childhood (OR = 0.082; 95% CI 0.009-0.739) and JADAS-10 in the disease onset (OR = 0.758; 95% CI 0.589-0.896) <6 points, treatment with IB in the history (OR = 0,767; 95% CI 0.054-0.811) and the duration of DMARDS treatment (OR = 0.741; 95% CI 0.636-0.863) > 1.5 years. The negative correlation of JADI-A and the patient’s physical well-being PCS (r = -0.27, p <0.05) and physical functioning (r = -0.24, p < 0.05), pain intensity (r = -0.24, p <0.05), general health (r = -0.24, p <0.05), vital activity (r = -0,19, p <0,05), social functioning (r = -0,27, p <0,05), mental health (r = -0,22, p <0,05) according to SF-36. The severity of extra-articular damages JADI-E correlated with PCS (r = -0.22, p <0.05) and physical functioning (r = -0.28, p<0.05), pain intensity (r = -0.20, p <0.05), general health (r = -0.23, p <0.05), and mental health (r = -0.23, p <0.05), but also had a positive correlation with HAM-A (r = 0.25, p <0.05), depression scale (r = 0.28, p <0.05) and PHQ-9 (r = 0.28, p <0.05). Significantly lower level of physical health was established in patients who requires prosthetics (p <0.001) compared to those who did not need prosthetics.

Conclusion:

Based on the obtained results, algorithms of management of adult patients with JIA oligoarthritis were developed, depending on the detected articular and extra-articular damages and the need for prosthetics and the psychological status.

Disclosure of Interests:

None declared

Cross-sectional Evaluation of the Sarcopenia Quality of Life (SarQoL) Questionnaire: Translation and Validation of its Psychometric Properties

BACKGROUND

The SarQoL, a quality-of-life questionnaire specific to sarcopenia, was developed in 2015 and has since been translated into a number of other languages. The main reason to introduce this new Ukrainian version of the questionnaire was to measure sarcopenic individuals' perceptions regarding their positions in life in the context of their culture and value systems.

METHODS

The questionnaire was translated using a forward-backward approach with a pre-test. A total of 49 participants were recruited for the validation study. Sarcopenia was diagnosed according to the Ishii test. The validation analyses included discriminative power, internal consistency, floor and ceiling effects, construct validity, and test-retest reliability. We compared the SarQoL questionnaire to the Short-Form 36 and the EuroQoL-5 Dimensions.

RESULTS

A total of 28 participants out of 49 were categorized as probably sarcopenic. They had a significantly lower quality of life (overall score 58.43±17.13 vs. 69.89±13.31; p=0.014). The internal consistency was excellent (α=0.898), with none of the domains showing a disproportionate influence on the homogeneity of the questionnaire. Convergent construct validity was also confirmed. The results indicated a near-perfect degree of test-retest reliability.

CONCLUSIONS

The first Ukrainian version of the questionnaire is equivalent to the available original English version.

Remission and Active Disease in Young Adult Patients with Juvenile Idiopathic Arthritis During the Transition Period from Paediatric to Adult Healthcare

The objective of the research was to study the frequency of remission in young adults with juvenile idiopathic arthritis during the transition period from paediatric to adult healthcare and factors contributing to its development.         Materials and methods. In our study, there were included 165 adult patients from different regions of Ukraine diagnosed with juvenile idiopathic arthritis according to the classification criteria of the International League of Associations for Rheumatology. All the patients were examined in the Oleksandrivska City Clinical Hospital, Kyiv during 2015-2018. There were assessed the presence of rheumatoid factor, anti-cyclic citrullinated peptide, antinuclear antibodies, human leukocyte antigen B27, disease duration, disease activity (the Juvenile Arthritis Disease Activity Score-10 and the Disease Activity Score-28), C-reactive protein, past medical history, quality of life (the 36-Item Short Form Health Survey), the degree of depression (the Patient Health Questionnaire-9) and alexithymia (the 20-item Toronto Alexithymia Scale). In all the patients, bone mineral density was studied using dual-energy x-ray absorptiometry with the evaluation of T- and Z-scores in different regions of the skeleton. The disease was considered inactive at the Disease Activity Score-28 <2.6 and the Juvenile Arthritis Disease Activity Score-10 <1 and <2 for oligoarticular and polyarticular variants of juvenile idiopathic arthritis, respectively.         Results and discussion. All the patients were divided into 2 groups: Group I included 136 (82.4%) patients with active disease at the time of examination; Group II comprised 29 (17.6%) patients who achieved remission according to the Disease Activity Score-28 or the Juvenile Arthritis Disease Activity Score-10. In Group I, females prevailed accounting for 58.1% of patients as compared to Group II (31.0%). Disease duration was longer in patients of Group I (p<0.01); however, they did not differ from patients of Group II in age at disease onset and the International League of Associations for Rheumatology variants of juvenile idiopathic arthritis. In Group II, lesions involving more than 3 joints (p<0.01), hand arthritis (p<0.01), symmetric arthritis (p<0.01), enthesitis (p<0.01), spinal pain (p<0.01) were observed less frequently. Fewer patients required joint replacement (p<0.01); the number of deformed and painful joints (p<0.05, p<0.001, respectively) was smaller. However, there was no difference in the level of rheumatoid factor, anti-cyclic citrullinated peptide, antinuclear antibodies, and the presence of human leukocyte antigen B27. The achievement of remission improved physical well-being of patients (the physical component score, p<0.001), although overall mental well-being (the mental component score) did not change according to the 36-Item Short Form Health Survey. In patients with remission, the indicators of physical functioning (p<0.001), role functioning (p<0.001), social functioning (p<0.001), bodily pain (p<0.001), general health (p<0.001), mental health (p<0.001) improved. There was observed a reduction in the level of depression to the normal one according to the Patient Health Questionnaire-9 (p<0.05); however, in both groups, there were observed elevated levels of alexithymia. Both groups did not differ in the frequency of immunobiological therapy prescription; however, the results should be intepreted with caution, since only 5 (17.1%) patients in Group II received immunobiological therapy earlier or at the time of examination. In Group II, patients did not receive glucocorticoids at the time of examination (p<0.001) and earlier more often (p<0.001). Both groups did not differ in both the duration of treatment with disease-modifying antirheumatic drugs and the doses of methotrexate and sulfasalazine.         Conclusions. Remission of juvenile idiopathic arthritis was detected in 17.6% of the surveyed young adult patients from different regions of Ukraine during the transition period from paediatric to adult healthcare, that indicated that in most cases the goal of treat-to-target strategy was not achieved. Patients with active disease often developed joint deformities and required their replacement; they had worse physical well-being according to the 36-Item Short Form Health Survey, although mental well-being was affected in both patients with active disease and those with remission, which may be due to high levels of alexithymia in both groups. Patients with active disease had higher levels of depression according to the Patient Health Questionnaire-9, whereas patients in remission showed no depression. 

Risk Factors for the Development of Low Quality of Life in Adults with Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis is known to persist into adulthood which is associated with the development of a large number of long-term consequences, including low quality of life.         The objective of the research was to evaluate quality of life in young adults with juvenile idiopathic arthritis and to analyze the risk factors for the development of its low level using the 36-Item Short Form Health Survey.     Materials and methods. There were examined 135 adult patients with juvenile idiopathic arthritis without severe comorbidity at the age of 18 to 40 years and 25 apparently healthy young adults of the same age and gender. Quality of life was evaluated using the 36-Item Short Form Health Survey.     Results. In patients with juvenile idiopathic arthritis, the physical health score (44.8±9.9) was lower (p=0.001) as compared to healthy individuals (55.7±6.9). Patients with juvenile idiopathic arthritis had lower indicators of physical functioning (p=0.001), role functioning (p=0.001) and bodily pain (p=0.001) than healthy individuals. However, in patients with juvenile idiopathic arthritis, the indicators of the mental health score and associated vitality, social functioning, role limitations due to emotional problems and mental health did not differ from those in the control group. Prolonged morning stiffness (p<0.05) and polyarticular variant of joint damage (p<0.05) were the risk factors for the development of low physical health score in young adults with juvenile idiopathic arthritis. According to the articular juvenile arthritis damage index (p<0.001), the presence of long-term articular damage was associated with high physical health score. There were found no risk factors for the development of low mental health score.      Conclusions. Young adults with juvenile idiopathic arthritis at the age of 18 to 40 years had worse quality of life than healthy individuals of the same age and gender. They had worse physical well-being scores including physical functioning, role functioning and bodily pain. The risk factors for the development of low physical health score in young adults with juvenile idiopathic arthritis were the presence of prolonged morning stiffness as a manifestation of disease activity and polyarticular variant of joint damage, while the presence of prosthetic joints improved their physical health score.

Long-Term Effects of Articular and Extra-Articular Damage in Adult Patients with Juvenile Idiopathic Arthritis and Different Immunogenic Markers

To assess the long-term effects of juvenile idiopathic arthritis in adulthood, unified diagnostic methods for articular and extra-articular lesions should be used which depend on the juvenile idiopathic arthritis variants, the disease activity and treatment. The objective of the research was to compare the clinical manifestations in adult patients with different juvenile idiopathic arthritis-specific immunogenic markers and to evaluate their impact on the long-term articular and extra-articular damage.Materials and methods. We observed 132 young patients with different juvenile idiopathic arthritis variants. According to genetic/immunological markers the following groups were formed:  Group I - 38 positive human leukocyte antigen B27 patients; Group II - 13 positive antinuclear antibody patients; Group III - 26 positive rheumatoid factor/anti-cyclic citrullinated peptide patients and Group IV - 55 patients with all negative markers. Long-term effects of juvenile idiopathic arthritis were estimated by the articular juvenile arthritis damage index (JADI-A) and the extra-articular juvenile arthritis damage index (JADI-E). Descriptive statistics, the Student’s T-test, the Fisher’s exact test and Mann-Whitney U-test were performed.Results. 70 women and 62 men with the disease duration of 13.6±9.3 years at the age of 24.3±8.3 years were included into the study: 12 (9.1%) patients with positive rheumatoid factor polyarthritis, 30 (22.7%) patients - with negative rheumatoid factor polyarthritis, 32 (24.2%) patients with persistent oligoarthritis, 19 (14.4%) patients with extendent oligoarthritis, 20 (15.2%) patients with entesitis-related arthritis and 19 (14.4%) patients with systemic arthritis; there were no patients with psoriatic arthritis. There were no differences between groups in age, disease-modifying antirheumatic drug cumulative dose, mean dose of prednisolone and quality of life according to the SF-36. In Group I, the delay in the diagnosis was more than one year (18.6±24.2 months). In this group, less painful (p<0.005) and deformed (p<0.01) joints as compared to Group ІІІ, and higher levels of the ESR and C-reactive protein as compared to Group ІV were found, although the Juvenile Arthritis Disease Activity Score index in childhood was lower (p<0.005) as compared to Group ІІ. They received a lower cumulative dose of the glucocorticoids as compared to Group II (p<0.01), respectively. They had lower (p<0.01) JADI-E as compared to Group II (1.31 ± 1.49) and lower (p <0.01) JADI-A as compared to Group III. In Group III, the diagnosis was made the fastest in comparison with other groups (6.4±8.4 months, p<0.05); more painful joints (p <0.05) and ankylosis (p<0.05) were observed as compared to Group I, JADI-A was significantly higher (p<0.05) in Group III as compared to Group I. The most pronounced JADI-A was found in Group III, while in Group I and Group II, this index was the lowest. JADI-E was the most pronounced in Group II, and the most favorable course was found in Group І and Group ІІІ (p<0.05).Conclusions. Presence of anti-cyclic citrullinated peptide/rheumatoid factor in adults with juvenile idiopathic arthritis has negative impact on joint damage (JADI-A) indicating the need for aggressive therapy in both childhood and adulthood. Presences of antinuclear antibodies are associated with more often extra-articular damages in adulthood as compared to other groups.