Update on noninfectious uveitis in children and its treatment

Curr Opin Rheumatol. 2020 Sep;32(5):395-402. doi: 10.1097/BOR.0000000000000723.

Abstract

Purpose of review: To give an overview of recently published articles covering risk factors, novel biomarkers and treatment for noninfectious uveitis in children.

Recent findings: In the last few years, several genetic markers, serum biomarkers, aqueous humor markers, tear biomarkers and clinical factors have been identified, which are associated with childhood noninfectious uveitis. We describe the most important reports in this field that may help to tailor the screening and monitoring of this population in the future and might become the target of novel therapies. The advances in the biologic therapy of paediatric uveitis, thanks to evidence provided by the SYCAMORE, ADJUVITE and APTITUDE trials, offer new possibilities for the treatment of patients who fail methotrexate with adalimumab and tocilizumab. We discuss the importance of comprehensive outcome measures as proposed by the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC).

Summary: Paediatric noninfectious uveitis is a sight-threatening condition and the identification of risk factors and novel biomarkers is critical for tailored management. Biologic therapies are revolutionizing the outcomes of patients resistant to conventional therapy. Increasing our knowledge of disease pathogenesis is crucial to improve targeting of screening to those at highest risk and stratification of treatments.

Publication types

  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / therapeutic use*
  • Biomarkers / metabolism
  • Child
  • Humans
  • Methotrexate / therapeutic use
  • Outcome Assessment, Health Care
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Uveitis / metabolism

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Biomarkers
  • Adalimumab
  • tocilizumab
  • Methotrexate