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Background Patients with JIA often present with signs and symptoms suggestive of infection. However, differentiation of infectious from non-infectious presentation in routine clinical care is challenging. Procalcitonin (PCT) is a serum biomarker elevated in the setting of bacterial infection, but whether it can reliably differentiate infection from disease flare in patients with JIA is unknown.[1 Objectives To test the hypothesis that PCT levels will differ between active JIA, quiescent JIA, bacteremic patients and healthy controls. Methods From 10/16–4/17, consecutive children 6 months – 18 years with a) active untreated JIA b) quiescent JIA and c) healthy pre-surgical candidates were recruited from a musculoskeletal specialty hospital. JIA was defined according to ILAR criteria. Patients with active JIA despite treatment were excluded, to avoid confounding by treatment. Consecutive bacteremic patients were identified from an associated paediatric intensive care unit over the same period. Descriptive statistics and univariate logistic analyses were performed as appropriate. Results Patient characteristics are summarised in Table 1; bacteremic patients were younger. PCT was elevated in bacteremic patients, and was undetectable in all other subjects (Table 2). There were trends towards higher ESR and CRP in bacteremic patients, but these were not statistically significant. Conclusions Serum PCT levels appear to be a reliable biomarker to distinguish infection vs. active JIA at presentation, and can aid in directing therapy. However, PCT does not appear useful to assess disease activity in JIA. Further studies are needed to assess utility of serum PCT measurement in differentiating JIA flares from less severe infections. Reference [1] Milcent K, et al., “Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants,”JAMA Pediatrics170, no. 1 (2016): 62–69; Mohsen A, et al., “Predictive Values for Procalcitonin in the Diagnosis of Neonatal Sepsis,” Electronic Physician 7, no. 4 (2015): 1190–95. Disclosure of Interest None declared

Background: The importance of patient-reported outcomes is increasingly recognized both in clinical care and in research. PROMIS is an NIH-supported collection of patient-reported outcome measures, covering a variety of domains that are designed without disease specificity. While ‘short forms’ have been studied in juvenile idiopathic arthritis (JIA), PROMIS computer adaptive tests (CATs) have not. Objectives: This study evaluates whether PROMIS CATs correlate with disease activity in patients with JIA. Methods: A convenience sample of patients with JIA (N=21) were recruited from a single center. Patients aged 10–17 years completed all available pediatric PROMIS CATs, and parents of patients aged 2–9 years completed all available parent proxy PROMIS CATs (fatigue, pain interference, peer relations, anxiety, depressive symptoms, and mobility). Correlation of the CATs t-scores with disease activity, as measured by the Juvenile Disease Activity Score-71 (JADAS-71), (0–101, higher being worse) was evaluated using Spearman correlation coefficients. Results: All families approached completed the PROMIS CATs: 13 patients and 8 parents (table 1). Median age was 12.7 years (range 1.3 – 18.6 years), and mean JADAS-71 score was 9.58 (SD 2.07). 69% of patients completed PROMIS CATs remotely via smartphone. Anxiety (r=0.74, p=0.006), depressive symptoms (r=0.84, p Conclusions: Our results demonstrate that the PROMIS CATs are feasible to administer in an outpatient pediatric rheumatology setting. Anxiety, depressive symptoms, and pain interference were significantly correlated with disease activity, even though mean disease activity was relatively low. This underscores the negative effect on quality of life of even mild disease. Parent proxy CATs showed poor correlations with disease activity, suggesting parents are inaccurate in assessing important aspects of their child’s health. Larger prospective studies are needed to evaluate the sensitivity of PROMIS CATS to change in disease activity over time. Disclosure of Interest: None declared

Background JIA is a chronic autoimmune disease that poses many challenges. There is increasing recognition of the importance of patient-reported outcomes (PROs) and newer PROs are being developed and more widely utilised both in clinical care and in research, However, their performance and reliability remain unclear. Objectives This study seeks to evaluate: 1 performance of the patient global health assessment (PGA) compared to standard disease activity measures in children with JIA, 2 correlations of the PGA with socioeconomic status (SES) in JIA, and 3 relationship between PGA and physician global health assessment in JIA. Methods A convenience sample of patients with JIA (n=47) aged 2–18 were recruited from a single centre. Patients aged ≥10 years completed the questionnaire, and parents of patients aged 2–9 completed a proxy questionnaire for their child. Correlations between 1 the PGA and disease activity, as measured by the Juvenile Disease Activity Score-71 (JADAS-71), 2 the PGA and physician global health assessment, and 3 the physician global health assessment and the JADAS-71 were evaluated using Spearman correlation coefficients. PGAs were compared by age, sex, insurance status, race, and ethnicity; and differences between PGA and physician global health assessments were compared using Wilcoxon rank-sum tests. Results 16 parents and 31 patients completed the assessments (table 1). There was a moderate correlation between PGA and JADAS-71 (r=0.503, p Conclusions Our results demonstrate that physician global health assessment had a stronger correlation with standard disease activity measures than the PGA. These scores were higher in patients who were non-White race, Hispanic, and had Medicaid insurance; however, these were not statistically significant. These data indicate that the PGA is fairly stable across groups, and can be used reliably for disease monitoring. Disclosure of Interest None declared