Treating juvenile idiopathic arthritis (JIA)-related uveitis beyond TNF-α inhibition: a narrative review.
Biologic therapy
Chronic anterior uveitis
Juvenile idiopathic arthritis
Rescue treatment
Journal
Clinical rheumatology
ISSN: 1434-9949
Titre abrégé: Clin Rheumatol
Pays: Germany
ID NLM: 8211469
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
22
03
2019
accepted:
22
08
2019
revised:
20
08
2019
pubmed:
12
12
2019
medline:
20
11
2020
entrez:
12
12
2019
Statut:
ppublish
Résumé
Chronic anterior uveitis is the most frequent among extra-articular manifestations of juvenile idiopathic arthritis (JIA) and a relevant cause of ocular morbidity in children. Asymmetric arthritis, early onset disease, female sex, and anti-nuclear antibody (ANA) positivity are counted among risk factors for developing this complication. It usually has insidious onset and asymptomatic chronic-relapsing course, but the persistence of low-grade chronic inflammation can lead to irreversible structural ocular damage and to vision-threatening complications. For such reasons, achieving a complete absence of inflammation through early targeted and aggressive treatments is a primary therapeutic goal in these patients. This review is aimed at summarizing scientific evidence about biologic rescue therapy of JIA-related uveitis in patients who fail to achieve clinical remission, in spite of being treated with conventional disease-modifying anti-rheumatic drugs (cDMARDs) and at least one biologic tumor necrosis factor (TNF)-α inhibitor. Interleukin (IL)-6 inhibition appears a promising and safe option for refractory JIA-related uveitis. Abatacept and rituximab proved to be beneficial as well, but their efficacy together with some safety concerns needs to be more extensively evaluated.
Identifiants
pubmed: 31823144
doi: 10.1007/s10067-019-04763-3
pii: 10.1007/s10067-019-04763-3
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Tumor Necrosis Factor Inhibitors
0
Rituximab
4F4X42SYQ6
Abatacept
7D0YB67S97
tocilizumab
I031V2H011
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
327-337Références
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