The efficacy of anti–TNF-α agents in the treatment of juvenile idiopathic arthritis-associated uveitis in a pediatric cohort

Abstract

Purpose: Biologic therapy has shown promising control in children with often intractable juvenile idiopathic arthritis (JIA)-associated uveitis (JIA-U). Methods: This is a retrospective cohort study of 35 eyes of 35 children who received biologics for JIA-U. Pretreatment and posttreatment data (at 3, 6, 9, 12, 18, 24, and >24 months) were analyzed to determine functional success (stable/improved visual acuity), quiescence success (≤0.5 cells in the anterior chamber), complete steroid success (termination of systemic, periocular therapy and decreased topical drops to ≤2/day) or systemic steroid success (termination of systemic steroids only), and complete success (all of the above). Results: This study included 35 eyes up to 12 months and 21 eyes beyond 24 months. Steroid-sparing, functional, and quiescence success showed a rate of success of 52.43%, 77%, and 91%, respectively, at 12 months and 66.67%, 85.7%, and 76.2%, respectively, beyond 24 months. Complete success was 34.29% at 12 months, peaking at 18 months (65.62%) and reached 57.14% beyond 24 months. In their final follow-up, the best corrected visual acuity (BCVA) remained the same in 45.71%, improved in 37.14%, and worsened in 17.14% children. Conclusion: Biologic therapy is effective in JIA-U, especially in termination of systemic steroids, stabilization of vision, and maintaining quiescence.

Keywords

• adalimumab
• biologics
• etanercept
• immunosuppressive therapy
• infliximab
• jia-u
• pediatrics
• uveitis