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Multicenter Study
. 2025 Mar 20;27(1):61.
doi: 10.1186/s13075-025-03531-w.

Course of uveitis in children with juvenile idiopathic arthritis (JIA): Five years follow-up data from a prospective multicenter Inception Cohort of Newly diagnosed patients with JIA (ICON-JIA) study

Karoline Baquet-Walscheid  1   2 , Kirsten Minden  3   4 , Martina Niewerth  3 , Frank Dressler  5 , Ivan Foeldvari  6 , Dirk Foell  7 , Johannes-Peter Haas  8 , Gerd Horneff  9   10 , Anton Hospach  11 , Tilmann Kallinich  12   13 , Jasmin Kümmerle-Deschner  14 , Kirsten Mönkemöller  15 , Christoph Tappeiner  2   16   17 , Daniel Windschall  18   19 , Jens Klotsche #  3 , Arnd Heiligenhaus #  20   21
Affiliations
Multicenter Study

Course of uveitis in children with juvenile idiopathic arthritis (JIA): Five years follow-up data from a prospective multicenter Inception Cohort of Newly diagnosed patients with JIA (ICON-JIA) study

Karoline Baquet-Walscheid et al. Arthritis Res Ther. .

Abstract

Background: Juvenile idiopathic arthritis-associated uveitis (JIAU) typically takes a chronic course, frequently leading to ocular complications and often requiring long-term treatment. The present study assesses the 5-years outcome of JIAU by analyzing data from a prospective study initiated in 2010.

Methods: Data from 75 patients with onset of uveitis after study enrollment, and with a documentation at 5-years follow-up (5yFU) were available for analysis of uveitis characteristics, frequency and predictors of "inactivity on medication " (defined as inactive uveitis for ≥ 6 months) and "inactivity off medication " (defined as inactive uveitis for ≥ 6 months off medication).

Results: At the 5yFU, visual acuity remained good in the majority of eyes (LogMAR < 0.1 in 65.5%; mean LogMAR 0.11 ± 0.31), ocular surgery was required in only 5% of patients, although complications occurred in 46.7% of patients until the 5yFU. Uveitis was inactive in 85.3% of patients, with 77.3% still receiving disease-modifying antirheumatic drugs (DMARDs). Until 5yFU, 82.7% of patients experienced ≥ one episode of "inactivity on medication " (30.7% once, 37.3% twice, 14.7% three or more times), and 17.3% ≥ one episode of "inactivity off medication ", respectively. Both "inactivity on medication " as well as "inactivity off medication " were associated with lower JIA disease activity (cJADAS10; ESR), and with an increased quality of life.

Conclusions: Despite intensified DMARD treatment, almost half of the children experience JIAU-related ocular complications after 5 years of disease; however, visual acuity mostly remains good. Uveitis inactivity can be achieved frequently, but is often limited in duration. Lower JIA activity appears to correlate with uveitis inactivity on and off medication.

Keywords: Biological therapy; Juvenile idiopathic arthritis; Prognosis; Uveitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Statement of ethics and consent: The ICON study was conducted in accordance with the Declaration of Helsinki and was approved by the ethics committee of the Charité, Universitätsmedizin Berlin (EA1/056/10). Parents and patients ≥ 8 years of age provided written informed consent for participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan Meier curve of uveitis „inactivity on medication “ and uveitis „inactivity off medication “ during follow-up. „Inactivity on medication “ was defined as inactive uveitis for at least 6 months; „inactivity off medication “ was defined as inactive uveitis for at least 6 months without topical corticosteroids and systemic anti-inflammatory medication (corticosteroids, DMARD)
See this image and copyright information in PMC

References

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