Update on the Treatment of Uveitis in Patients with Juvenile Idiopathic Arthritis: A Review

Asproudis, Ioannis; Katsanos, Andreas; Kozeis, Nikolaos; Tantou, Alexandra; Konstas, Anastasios G. P.

doi:10.1007/s12325-017-0635-3

Cited by 11 publications

(8 citation statements)

References 41 publications

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“…Although the standard ANA test is not particularly helpful in predicting arthritis outcomes in JIA, its prognostic utility for the risk of developing JIA-associated uveitis is clear. Specifically, patients with oligo- or poly-articular JIA with ANA positivity tend to develop disease at a younger age, have asymmetric patterns of arthritis, and are at an increased risk of developing chronic anterior uveitis (39, 40). This form of uveitis is typically asymptomatic.…”

Section: Ana and Jia Prognosismentioning

confidence: 99%

Autoantibodies in the Pathogenesis, Diagnosis, and Prognosis of Juvenile Idiopathic Arthritis

Mahmud

Binstadt

2019

Front. Immunol.

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Autoantibody production occurs in juvenile idiopathic arthritis (JIA) and numerous other autoimmune diseases. In some conditions, the autoantibodies are clearly pathogenic, whereas in others the roles are less defined. Here we review various autoantibodies associated with JIA, with a particular focus on antinuclear antibodies and antibodies recognizing citrullinated self-antigens. We explore potential mechanisms that lead to the development of autoantibodies and the use of autoantibody testing in diagnosis and prognosis. Finally, we compare and contrast JIA-associated autoantibodies with those found in adults with rheumatoid arthritis (RA).

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Section: Ana and Jia Prognosismentioning

confidence: 99%

Autoantibodies in the Pathogenesis, Diagnosis, and Prognosis of Juvenile Idiopathic Arthritis

Mahmud

Binstadt

2019

Front. Immunol.

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“…Some children received subconjunctival injections of long-acting steroids or an intravitreal implant of dexamethasone. Their use in children is currently controversial, they are not evaluated as a perioperative management tool [ 25 ] and further studies are needed to quantify the risk of secondary glaucoma and steroid-induced cataract [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice

Molimard

Pajot²,

Ollé

et al. 2021

Pediatr Rheumatol

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Background Surgeries for idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children are complex because of the high risk of inflammatory postoperative complications. There is no consensus about treatment adaptation during the perioperative period. The objectives of this study are to report the therapeutic changes made in France and to determine whether maintaining or stopping immunosuppressive therapies is associated with an increased risk of surgical site infection or an increased risk of uveitis or arthritis flare-up. Methods We conducted a retrospective cohort study between January 1, 2006 and December 31, 2018 in six large University Hospitals in France. Inclusion criteria were chronic idiopathic uveitis or chronic uveitis associated with juvenile idiopathic arthritis under immunosuppressive therapies at the time of the surgical procedure, operated before the age of 16. Data on perioperative treatments, inflammatory relapses and post-operative infections were collected. Results A total of 76 surgeries (42% cataract surgeries, 30% glaucoma surgeries and 16% posterior capsule opacification surgeries) were performed on 37 children. Adaptation protocols were different in the six hospitals. Immunosuppressive therapies were discontinued in five cases (7%) before surgery. All the children in the discontinuation group had an inflammatory relapse within 3 months after surgery compared to only 25% in the other group. There were no postoperative infections. Conclusions The results of this study show varying practices between centres. The benefit-risk balance seems to favour maintaining immunosuppressive therapies during surgery. Further studies are needed to determine the optimal perioperative treatments required to limit post-operative inflammatory relapses.

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“…As shown in the present patient, adalimumab is now the standard therapy for juvenile idiopathic arthritis-associated uveitis with retinal complications such as macular edema. [43][44][45][46][47][48][49] In this context, liaison between ophthalmologists and pediatricians is crucial not to miss a chance to rescue the vision by starting adalimumab. Concurrent with the present report, case series of Japanese patients with juvenile idiopathic arthritis-associated uveitis were reported by pediatricians.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Control of Macular Edema With Adalimumab After Cataract Surgery in a Japanese Child With Juvenile Idiopathic Arthritis: Case Report and Review of 26 Japanese Patients

Matsuo

Yashiro

2020

Journal of Investigative Medicine High Impact Case Reports

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Juvenile idiopathic arthritis–associated uveitis is rare in the Japanese population. In this article, we report a child whose macular edema was controlled for years after cataract surgery with adalimumab, and reviewed 26 Japanese patients in the literature. In this case report, a 4-year-old boy developed band keratopathy, posterior iris synechiae, and complicated cataract in both eyes. Oral prednisolone prescribed at another hospital was discontinued due to high intraocular pressure in both eyes as a steroid responder. At the age of 5 years, he started oral methotrexate 8 mg weekly for recurrent bilateral iridocyclitis and then underwent lensectomy with core vitrectomy in both eyes. Planned intraocular lens implantation was cancelled at surgery because the anterior vitreous had severe inflammatory opacity with diffuse retinal edema in both eyes. Due to persistent macular edema in both eyes 5 months postoperatively, at the age of 6 years, he began to use adalimumab injection 20 mg every 2 weeks. The macular structure depicted by optical coherence tomography became normal in 2 months. At final visit at the age of 11 years, he had the best-corrected visual acuity of 0.8 in the right eye and 0.4 in the left eye, with adalimumab 40 mg every 2 weeks and methotrexate 8 mg weekly. In conclusion, macular edema persistent despite oral methotrexate after cataract surgery could be controlled for long term by adalimumab in a child with juvenile idiopathic arthritis. In the Japanese literature, only 26 additional cases with juvenile idiopathic arthritis–associated uveitis have been reported so far.

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Update on the Treatment of Uveitis in Patients with Juvenile Idiopathic Arthritis: A Review

Cited by 11 publications

References 41 publications

Autoantibodies in the Pathogenesis, Diagnosis, and Prognosis of Juvenile Idiopathic Arthritis

Autoantibodies in the Pathogenesis, Diagnosis, and Prognosis of Juvenile Idiopathic Arthritis

Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice

Long-Term Control of Macular Edema With Adalimumab After Cataract Surgery in a Japanese Child With Juvenile Idiopathic Arthritis: Case Report and Review of 26 Japanese Patients

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