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

Indian J Ophthalmol. 2023 May;71(5):2168-2174. doi: 10.4103/IJO.IJO_2548_22.

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; JIA-U; biologics; etanercept; immunosuppressive therapy; infliximab; pediatrics; uveitis.

Publication types

  • Comment

MeSH terms

  • Adalimumab
  • Arthritis, Juvenile* / complications
  • Arthritis, Juvenile* / diagnosis
  • Arthritis, Juvenile* / drug therapy
  • Child
  • Humans
  • Retrospective Studies
  • Tumor Necrosis Factor Inhibitors
  • Tumor Necrosis Factor-alpha
  • Uveitis* / diagnosis
  • Uveitis* / drug therapy
  • Uveitis* / etiology

Substances

  • Tumor Necrosis Factor-alpha
  • Adalimumab
  • Tumor Necrosis Factor Inhibitors