The aim of this review is to highlight recent changes in the treatment of juvenile idiopathic arthritis (JIA) – associated uveitis in the era of biologics.
Early introduction of steroid-sparing therapies is paramount for appropriate management. Biologic therapies have improved the therapeutic management of JIA-uveitis and adalimumab is currently approved for pediatric-onset noninfectious chronic anterior uveitis with an inadequate response to topical steroids and methotrexate. Recent studies suggest that ocular complications in JIA-uveitis are less frequent compared with previous publications. However, patients with JIA-uveitis seem to be particularly dependent on classical immunosuppressive drugs or biologics. Indications for primary lens implantation have expanded considerably with the evolution of materials and better control of inflammation with biologics. The rate of serious adverse events related to new therapeutic approaches seem acceptable, however longer term follow-up is necessary.
Improvement in the initial screening and improved inflammation control with biologics has considerably reduced the potentially sight-threatening prognosis of JIA-uveitis.
aDepartment of Ophthalmology – Charles Nicolle University Hospital, Rouen
bDepartment of Ophthalmology, IHU FORESIGHT, Pitié-Salpêtrière Hospital, APHP, Sorbonne-University
cImmunology-Hematology and Rheumatology Unit, RAISE Reference Centre, Imagine Institute, Paris-Descartes University, Pediatric Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
Correspondence to Julie Gueudry, Department of Ophthalmology, Charles Nicolle Hospital, 22 Boulevard Gambetta, 76031 Rouen, France. Tel: +33 2 32 88 80 57; fax: +33 2 32 88 80 46; e-mail: firstname.lastname@example.org