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Systematic review on treatment of juvenile idiopathic arthritis – associated uveitis

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Background

Juvenile idiopathic arthritis (JIA) is commonly complicated by chronic uveitis that frequently leads to visual loss.

Methods

Review of the current literature on the treatment of JIA - associated uveitis.

Results

Therapy of JIA-associated uveitis is guided by the severity of inflammation and complications. Topical corticosteroids are generally used as the initial treatment. Severe uveitis is commonly treated with immunosuppressive drugs. Methotrexate is presently the first-choice agent. If uveitis is not responding, another immunosuppressive agent or biological is applied. Currently, adalimumab is the preferred TNF-inhibitor. In refractory disease, other biologicals are used (e.g., rituximab, tocilizumab or abatacept). Ocular corticosteroid injections / - implantations are considered as “rescue therapy”.

Conclusions

Controlled studies are warranted to offer most effective and safe therapy for children with JIA - associated uveitis. Better knowledge of the basic mechanisms underlying the disease and of the molecules that are important for regulating inflammation may help to create new and more specific treatment approaches, and to improve disease monitoring.

Disclosure of interest

None declared.

Author information

Correspondence to Arnd Heiligenhaus.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Heiligenhaus, A. Systematic review on treatment of juvenile idiopathic arthritis – associated uveitis. Pediatr Rheumatol 12, I6 (2014). https://doi.org/10.1186/1546-0096-12-S1-I6

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Keywords

  • Corticosteroid
  • Methotrexate
  • Juvenile Idiopathic Arthritis
  • Uveitis
  • Adalimumab