Anti-tumour necrosis factor (anti-TNF) in the treatment of juvenile idiopathic arthritis-associated uveitis

Introduction

Chronic uveitis is associated with JIA in about 15–30% of cases. Treatment with anti-TNF agents is very effective in JIA, but their efficacy for uveitis is controversial. We present here the preliminary results of a retrospective case series of uveitis associated of JIA and treated by different anti-TNF.

Objective

To evaluate the efficacy of TNF inhibitors in JIA-associated uveitis, as well as report the cases of uveitis associated with the use of anti-TNF.

Methods

The data of 16 patients with JIA and uveitis receiving anti-TNF were collected retrospectively in three French centers.

Results

Of the 16 patients, 10 were treated with etanercept (62.5%), 1 with adalimumab (6.25%), and 5 (31.2%) with infliximab. Notably, two cases of uveitis were associated with use of etanercept. In 5 patients (31.2%) the anti-TNF was changed because of lack of efficacy and/or side effects to another one (in 4/5 adalimumab). Ten patients had a complicated uveitis (cataract in 5). The number of relapses of uveitis was 4 ± 1.35 with the first anti-TNF, and 1.3 ± 1.5 with the second one. Remission of uveitis was obtained in 4 cases, 3 of them with adalimumab and one case with etanercept.

Conclusion

Anti-TNF agents have a favourable effect in JIA-associated uveitis, but adalimumab and perhaps infliximab may be more effective than etanercept, during which treatment uveitis may even develop.