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Review
. 2024 Sep;38(3):101979.
doi: 10.1016/j.berh.2024.101979. Epub 2024 Jul 23.

Management of JIA associated uveitis

Ilaria Maccora  1 , Gabriele Simonini  2 , Catherine M Guly  3 , Athimalaipet V Ramanan  4
Affiliations
Review

Management of JIA associated uveitis

Ilaria Maccora et al. Best Pract Res Clin Rheumatol. 2024 Sep.

Abstract

Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in childhood, and is associated with uveitis in up to 20-25% of cases. Typically, the uveitis is chronic, asymptomatic, non-granulomatous and anterior. For this reason, screening for uveitis is recommended to identify uveitis early and allow treatment to prevent sight-threatening complications. The management of JIA associated uveitis requires a multidisciplinary approach and a close collaboration between paediatric rheumatologist and ophthalmologist. Starting the appropriate treatment to control uveitis activity and prevent ocular complications is crucial. Current international recommendations advise a step-wise approach, starting with methotrexate and moving on to adalimumab if methotrexate alone is not sufficient to control the disease. If the uveitis remains active despite standard treatment other therapeutic options may be considered including anti-IL6 or other anti-TNF agents such as infliximab, although the evidence for these agents is limited.

Keywords: Adalimumab; Baricitinib; Infliximab; JIA; Juvenile idiopathic arthritis; Management; Tocilizumab; Tofacitinib; Uveitis.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Catherine Guly reports a relationship with Eli Lilly and Company that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with Eli Lilly and Company that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with AbbVie Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with Pfizer that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with Alimera Sciences Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with Roche that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with Novartis that includes: consulting or advisory, funding grants, and speaking and lecture fees. Athimalaipet V Ramanan reports a relationship with UCB Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Gabriele Simonini reports a relationship with AbbVie Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Gabriele Simonini reports a relationship with Sobi Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Gabriele Simonini reports a relationship with Novartis that includes: consulting or advisory, funding grants, and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

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