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Table 2 Biological immunosuppressants used in treatment of chronic anterior uveitis associated with JIA

From: Juvenile idiopathic arthritis-associated uveitis

Target

Drug name

Drug class

Dosage and route

Evidence

Key references

TNFα

Etanercept

Dimeric fusion protein

Not recommended for treatment of JIA-U

RCT: no more effective than placebo. Case reports of new uveitis on etanercept

[60, 61]

Infliximab

Chimeric (mouse-human) mAb

6 mg/kg IV initially, then 3–10 mg/kg. 2nd dose at 2 weeks, then every 4–8 weeks depending on response

Several case series showing efficacy

[61]

Adalimumab

Fully human mAb

24 mg/m2 sc q2w

Several case series showing efficacy. RCTs in progress

[61, 90]

In practice often 20 mg sc q2w (body weight <30 kg), 40 mg sc q2w (body weight ≥30 kg)

Golimumab

Fully human mAb

50 mg sc q4w

Case series (n = 3) showing efficacy

[103]

IL-6

Tocilizumab

Humanised mAb

10 mg/kg (body weight <30 kg), 8 mg/kg (body weight >30 kg) IV q4w

Case series (n = 3) and case report showing efficacy. Phase II trial in progress

[92, 93, 104, 105]

CD80/86 (CTLA4)

Abatacept

Fully human fusion protein

10 mg/kg IV at weeks 0, 2, 4 then q4w

Case series (n = 7 and n = 2) showing efficacy. Lack of sustained response in severe uveitis (n = 21)

[94, 106–108]

CD20

Rituximab

Chimeric (mouse-human) mAb

375 mg/m2 or 750 mg/m2 IV, two doses 2 weeks apart

Case series (n = 10 and n = 8 with long-term follow-up) showing efficacy in most patients

[109–111]

  1. Legend: CTLA-4 cytotoxic T-lymphocyte-associated antigen 4, IL interleukin, IV intravenous, JIA-U juvenile idiopathic arthritis-associated uveitis, mAb monoclonal antibody, od once daily, ow once per week, q2w every 2 weeks, q4w every 4 weeks, RCT randomised controlled trial, sc subcutaneous, TNF tumour necrosis factor