Background: Therapeutic inertia (IT) in rheumatic diseases is defined as inability to initiate or intensify therapy when recommended. It has been studied and identified as a major reason for poor outcomes in different diseases. Therefore, IT in juvenile idiopathic arthritis (JIA) is underestimated.

Objectives: We aimed to assess therapeutic inertia in JIA patients and to understand its contributing factors.

Methods: This was a cross-sectional study employing an anonymous questionnaire distributed via email to rheumatologists practitioners across both private and public sectors. The questionnaire was meticulously designed using the Google Forms® web application to explore their practical attitudes regarding JIA through eight clinical vignettes elaborated according to the most recent JIA recommendations (ACR EULAR 2019).

Results: We collected responses from 31 specialist. The mean age of participants was 29,67 ± 6.69 years (ranging from 26 to 43 years old). The majority of the specialists practice in the public sector, accounting for 93,5 %, while 6,5 % practice in the private sector. Twenty four participant had seen at least 1 patient with JIA through the last month.The majority of participants (90,3 %) faced a difficulty while instauring or renewing treatment for children with JIA.Most of the participants expressed doubt and uncertainty while treating a patient with JIA with respective agreement from 74,2% and 61,3%. Nearly half of the participants (43 %) demonstrated TI on at least two of the eight cases that needed a treatment optimization. Twenty-eight participants (90,3 %) expressed their prehension to escalating treatment in JIA. The drugs identified to raise a concern while their prescription were Specific biological disease-modifying anti-rheumatic drugs (bDMARDs), NSAIDs, immunosuppressives, with respective agreement from 74,2%, 58,1%, 48,4%. The forms inducing the most TI were systemic JIA and Enthesitis-related arthritis. Predictors for not switching to a different treatment, when it’s recommended, were, according to our participants, the multiple side effects (90,3%), the young age (71%), the unavailability of the treatment (45,2%), the poor economic status of the patient and social coverage issues (41,9%).

Conclusion: In order to ensure a better management of JIA, we need to focus more on this topic during training and scientific events. Remember, children can bounce back well with treatment, but acting early and efficiently is crucial.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.