nach oben

Erschienen in:

01.05.2012 | Review

Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis

verfasst von: A. Heiligenhaus, H. Michels, C. Schumacher, I. Kopp, U. Neudorf, T. Niehues, H. Baus, M. Becker, B. Bertram, G. Dannecker, C. Deuter, I. Foeldvari, M. Frosch, G. Ganser, M. Gaubitz, G. Gerdes, G. Horneff, A. Illhardt, F. Mackensen, K. Minden, U. Pleyer, M. Schneider, N. Wagner, M. Zierhut

Erschienen in: Rheumatology International | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

Uveitis in juvenile idiopathic arthritis (JIA) is frequently associated with the development of complications and visual loss. Topical corticosteroids are the first-choice therapy, and immunosuppression is commonly used. However, treatment has not been standardized. Representatives from the German Ophthalmological Society, Society for Childhood and Adolescent Rheumatology, and the German Society for Rheumatology reached consensus on a standardized treatment strategy according to disease severity in the individual patient. The recommendations were based on a systematic literature analysis in MEDLINE and consensus expert meetings. Evidence and recommendations were graded, and an algorithm for anti-inflammatory treatment and final statements confirmed in a Delphi method. An interdisciplinary, evidence-based treatment guideline for JIA uveitis is presented.

Kotaniemi K, Aho K, Kotaniemi A (2001) Uveitis as a cause of visual loss in arthritides and comparable conditions. J Rheumatol 28:309–312PubMed

Smith JA, Mackensen F, Sen HN, Leigh JF, Watkins AS, Pyatetsky D, Tessler HH, Nussenblatt RB, Rosenbaum JT, Reed GF, Vitale S, Smith JR, Goldstein DA (2009) Epidemiology and course of disease in childhood uveitis. Ophthalmology 116:1544–1551PubMedCrossRef

Kanski JJ (1977) Anterior uveitis in juvenile rheumatoid arthritis. Arch Ophthalmol 95:1794–1797PubMedCrossRef

Kanski JJ (1990) Juvenile arthritis and uveitis. Surv Ophthalmol 34:253–267PubMedCrossRef

Cabral DA, Petty RE, Malleson PN, Ensworth S, McCormick AQ, Shroeder M-L (1994) Visual prognosis in children with chronic anterior uveitis and arthritis. J Rheumatol 21:2370–2375

Carvounis PE, Herman DC, Cha S, Burke JP (2006) Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature. Graefe´s Arch Clin Exp Ophthalmol 244:281–290

Chia A, Lee V, Graham EM et al (2003) Factors related to severe uveitis at diagnosis in children with juvenile idiopathic arthritis in a screening program. Am J Ophthalmol 35:757–762CrossRef

Dana MR, Merayo-Lloves J, Schaumberg DA, Foster CS (1997) Visual outcomes prognosticators in juvenile rheumatoid arthritis-associated uveitis. Ophthalmology 104:236–244PubMed

De Boer J, Wulffraat N, Rothova A (2003) Visual loss in uveitis of childhood. Br J Ophthalmol 87:879–884PubMedCrossRef

10.

Edelsten C, Reddy A, Stanford MR et al (2003) Visual loss associated with paediatric uveitis in English primary and referral centers. Am J Ophthalmol 135:676–680PubMedCrossRef

11.

Holland GN, Denove CS, Yu F (2009) Chronic anterior uveitis in children: clinical characteristics and complications. Am J Ophthalmol 147:667–678PubMedCrossRef

12.

Kotaniemi K, Kautiainen H, Karma A, Aho K (2001) Occurrence of uveitis in recently diagnosed juvenile chronic arthritis. A prospective study. Ophthalmology 108:2071–2075PubMedCrossRef

13.

Petty RE, Smith JR, Rosenbaum JT (2003) Arthritis and uveitis in children. A pediatric rheumatology perspective. Am J Ophthalmol 135:879–884PubMedCrossRef

14.

Mingels A, Hudde T, Heinz C et al (2005) Vision threatening complications in uveitis in childhood. Ophthalmologe 105:477–484CrossRef

15.

Minden K, Mingels A, Niewerth M, Heiligenhaus A, Ganser G (2007) Juvenile idiopathische Arthritis und Uveitis: Epidemiologie einschließlich der Daten aus der Kerndokumentation. Klin Monatsbl Augenheilk 224:469–472CrossRef

16.

Thorne JE, Woreta F, Kedhar SR et al (2007) Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss. Am J Ophthalmol 143:840–846PubMedCrossRef

17.

Wolf MD, Lichter PR, Ragsdale CG (1987) Prognostic factors in the uveitis of juvenile rheumatoid arthritis. Ophthalmology 94:1242–1248PubMed

18.

Zulian F, Martini G, Falcini F, Gerloni V, Zannin ME, Pinello L, Fantini F, Facchin P (2002) Early predictors of severe course of uveitis in oligoarticular juvenile idiopathic arthritis. J Rheumatol 29:2446–2453PubMed

19.

Heiligenhaus A, Niewerth M, Ganser G et al (2007) Prevalence and complications of uveitis in juvenile idiopahic arthritis in a population-based nation-wide study in Germany: suggested modification of the current screening guidelines. Rheumatology 46:1015–1019PubMedCrossRef

20.

Cassidy J, Kivlin J, Lindsley C, Nocton J, The Section on Rheumatology and the Section on Ophthalmology (2006) Ophthalmic examinations in children with juvenile rheumatoid arthritis. Pediatrics 117:1843–1845PubMedCrossRef

21.

Neudorf U, Heiligenhaus A (2004) Konsensus-Statement für die Behandlung der Uveitis bei juveniler idiopathischer Arthritis. Monatsschrift Kinderheilk 152:1240–1248CrossRef

22.

Michels H, Heiligenhaus A, Neudorf U et al (2005) Rheumatische Uveitis. Leitlinien Pädiatrie. Elsevier, Urban & Fischer

23.

Guellac N, Niehues T (2008) Interdisciplinary and evidenz-based treatment guideline for juvenile idiopathic arthritis. Klin Pädiatr 220:392–402PubMedCrossRef

24.

Encke A, Kopp I, Selbmann HK, Hoppe J, Köhler A, Ollenschläger G (2005) Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Ärztliches Zentrum für Qualität in der Medizin (ÄZQ), and (Hrsg). Deutsches Instrument zur methodischen Bewertung von Leitlinien: DELBI. Dt.Ärztebl 102:1912–1913

25.

Ärztliches Zentrum für Qualität in der Medizin (ÄZQ) AdWMFA (2005) Deutsches Instrument zur methodischen Leitlinien-Bewertung (DELBI) Fassung 2005/2006. Z Ärztl Fortbild Qualitätssich 99:468–519

26.

Petty RE, Southwood TR, Manners P et al (2004) International League of Associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton 2001. J Rheumatol 31:390–392PubMed

27.

Brewer EJ Jr, Bass J, Baum J, Cassidy JT, Fink C, Jacobs J, Hanson V, Levinson JE, Schaller J, Stillman JS (1977) Current proposed revision of JRA criteria. JRA criteria subcommittee of the diagnostic and therapeutic criteria committee of the American rheumatism section of the arthritis foundation. Arthritis Rheum 20:195–199PubMed

28.

Fantini F (1977) Rheumatoid arthritis in children and related forms. Updating of nomenclature, nosography, clinical manifestations and therapy, with reference to the EULAR/WHO workshop on the care of rheumatic children, Oslo, March 1977. Reumatismo 29:7–32PubMed

29.

Wood P (1978) Special meeting on: nomenclature and classification of arthritis in children. In: Munthe E (ed) The care of rheumatic children. EULAR Publishers, Basle, pp 47–50

30.

Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516PubMedCrossRef

31.

Dunne JA, Travers JP (1979) Double-blind clinical trial of topical steroids in anterior uveitis. Br J Ophthalmol 63:762–767PubMedCrossRef

32.

Davis JL, Davis JL, Dacanay LM, Holland GN et al (2003) Laser flare photometry and complications of chronic uveitis in children. Am J Ophthalmol 135:763–771PubMedCrossRef

33.

Nussenblatt RB, Palestine AG, Chan CC, Roberge F (1985) Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology 1992:467–471

34.

Dunne JA, Jacobs N, Morrison A, Gilbert DJ (1985) Efficacy in anterior uveitis of two known steroids and topical tolmetin. Br J Ophthalmol 69:120–125PubMedCrossRef

35.

Gaudio PA (2004) A review of evidence guiding the use of corticosteroids in the treatment of intraocular inflammation. Ocul Immunol Inflamm 12:169–192PubMedCrossRef

36.

Ozerdem U, Levi L, Cheng L, Song MK, Scher C, Freeman WR (2000) Systemic toxicity of topical and periocular corticosteroid therapy in an 11-year-old male with posterior uveitis. Am J Ophthalmol 130:240–241PubMedCrossRef

37.

Kroger L, Kotaniemi K, Jaaskelainen J (2009) Topical treatment of uveitis resulting in adrenal insufficiency. Acta Paediatr 98:584–585PubMedCrossRef

38.

Sand BB, Krogh E (1991) Topical indometacin, a prostaglandin inhibitor, in acute anterior uveitis. A controlled clinical trial of non-steroid versus steroid anti-inflammatory treatment. Acta Ophthalmol (Copenh) 69:145–148CrossRef

39.

Young BJ, Cunningham WF, Akingbehin T (1982) Double-masked controlled clinical trial of 5% tolmetin versus 0.5% prednisolone versus 0.9% saline in acute endogenous nongranulomatous anterior uveitis. Br J Ophthalmol 66:389–391PubMedCrossRef

40.

Olson NY, Lindsley CB, Godfrey WA (1988) Nonsteroidal anti-inflammatory drug therapy in chronic childhood iridocyclitis. Am J Dis Child 142:1289–1292PubMed

41.

Giordano M (1983) Dauerprophylaxe der rezidivierenden spondylitischen Iridozyklitis durch Antimalarika und nichtsteroidale Antiphogistika. Z Rheumatol 41:105–106

42.

Chylack LT Jr, Bienfang DC, Bellows AR, Stillman JS (1975) Ocular manifestations of juvenile rheumatoid arthritis. Am J Ophthalmol 79:1026–1033PubMed

43.

Wakefield D, McCluskey P, Penny R (1986) Intravenous pulse methylprednisolone therapy in severe inflammatory eye disease. Arch Ophthalmol 104:847–851PubMedCrossRef

44.

Thurau SR, Frosch M, Zierhut M, Gumbel H, Heiligenhaus A (2007) Topical and systemic corticosteroid therapy for uveitis in childhood. Klin Monatsbl Augenheilkd 224:516–519PubMedCrossRef

45.

Fan DS, Yu CB, Chiu TY, Wong CY, Ng JS, Pang CP, Lam DS (2003) Ocular-hypertensive and anti-inflammatory response to rimexolone therapy in children. Arch Ophthalmol 121:1716–1721PubMedCrossRef

46.

Foster CS, Alter G, DeBarge LR, Raizman MB, Crabb JL, Santos CI, Feiler LS, Friedlaender MH (1996) Efficacy and safety of rimexolone 1% ophthalmic suspension vs 1% prednisolone acetate in the treatment of uveitis. Am J Ophthalmol 122:171–182PubMed

47.

Thorne JE, Woreta FA, Dunn JP, Jabs DA (2010) Risk of cataract development among children with juvenile idiopathic arthritis-related uveitis treated with topical corticosteroids. Ophthalmology 117:1436–1441PubMedCrossRef

48.

Giannini EH, Brewer EJ, Kuzmina N, Shaikov A, Maximov A, Vorontsov I, Fink CW, Newman AJ, Cassidy JT, Zemel LS (1992) Methotrexate in resistant juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind, placebo-controlled trial. The Pediatric Rheumatology Collaborative Study Group and The Cooperative Children’s Study Group. N Engl J Med 326:1043–1049PubMedCrossRef

49.

Hemady R, Tauber J, Foster CS (1991) Immunosuppressive drugs in immune and inflammatory ocular disease. Surv Ophthalmol 35:369–385PubMedCrossRef

50.

Kempen JH, Gangaputra S, Daniel E, Levy-Clarke GA, Nussenblatt RB, Rosenbaum JT, Suhler EB, Thorne JE, Foster CS, Jabs DA, Helzlsouer KJ (2008) Long-term risk of malignancy among patients treated with immunosuppressive agents for ocular inflammation: a critical assessment of the evidence. Am J Ophthalmol 146:802–812PubMedCrossRef

51.

Niehues T, Winterhalter S, Zierhut M, Michels H, Becker MD, Heiligenhaus A (2007) EBM analysis: classic DMARDs (disease-modifying antirheumatic drugs) and immunosuppressants in arthritis and uveitis. Klin Monatsbl Augenheilkd 224:520–525PubMedCrossRef

52.

Chan AY, Liu DT (2006) Methotrexate and chronic uveitis associated with juvenile idiopathic arthritis. J Rheumatol 33:198PubMed

53.

Foeldvari I, Wierk A (2005) Methotrexate is an effective treatment for chronic uveitis associated with juvenile idiopathic arthritis. J Rheumatol 32:362–365PubMed

54.

Heiligenhaus A, Mingels A, Heinz C, Ganser G (2007) Methotrexate for uveitis associated with juvenile idiopathic arthritis: value and requirement for additional anti-inflammatory medication. Eur J Ophthalmol 17:743–748PubMed

55.

Lazar M, Weiner MJ, Leopold IH (1969) Treatment of uveitis with methotrexate. Am J Ophthalmol 67:383–387PubMed

56.

Malik AR, Pavesio C (2005) The use of low dose methotrexate in children with chronic anterior and intermediate uveitis. Br J Ophthalmol 89:806–808PubMedCrossRef

57.

Samson CM, Waheed N, Baltatzis S, Foster CS (2001) Methotrexate therapy for chronic noninfectious uveitis: analysis of a case series of 160 patients. Ophthalmology 108:1134–1139PubMedCrossRef

58.

Shetty AK, Zganjar BE, Ellis GS Jr, Ludwig IH, Gedalia A (1999) Low-dose methotrexate in the treatment of severe juvenile rheumatoid arthritis and sarcoid iritis. J Pediatr Ophthalmol Strabismus 36:125–128PubMed

59.

Weiss AH, Wallace CA, Sherry DD (1998) Methotrexate for resistant chronic uveitis in children with juvenile rheumatoid arthritis. J Pediatr 133:266–268PubMedCrossRef

60.

Ruperto N, Murray KJ, Gerloni V et al (2004) A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate. Arthritis Rheum 50:2191–2201PubMedCrossRef

61.

Niehues T, Horneff G, Michels H, Hock MS, Schuchmann L (2005) Evidence-based use of methotrexate in children with rheumatic diseases: a consensus statement of the Working Groups Pediatric Rheumatology Germany (AGKJR) and Pediatric Rheumatology Austria. Rheumatol Int 25:169–178PubMedCrossRef

62.

Kvien TK, Hoyeraal HM, Sandstad B (1986) Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single center double blind comparative study. J Rheumatol 13:118–123PubMed

63.

Savolainen HA, Kautiainen H, Isomaki H, Aho K, Verronen P (1997) Azathioprine in patients with juvenile chronic arthritis: a longterm followup study. J Rheumatol 24:2444–2450PubMed

64.

Goebel J, Roesel M, Heinz C, Michels H, Ganser G, Heiligenhaus A (2011) Azathioprine as a treatment option for uveitis in patients with juvenile idiopathic arthritis. Br J Ophthalmol 95:209–213PubMedCrossRef

65.

Schlote T, Dannecker G, Thiel HJ, Zierhut M (1996) Cyclosporin A in therapy of chronic uveitis in childhood. Ophthalmologe 93:745–748PubMedCrossRef

66.

Kilmartin DJ, Forrester JV, Dick AD (1998) Cyclosporin A therapy in refractory non-infectious childhood uveitis. Br J Ophthalmol 82:737–742PubMedCrossRef

67.

Foeldvari I, Nielson S, Tzaribachev N, Quitsch J, Dressler F, Hilario M, Küster R, Borte M, Mazur-Zielinski H, Jäger-Roman E, Wierk A (2006) Results of a multinational survey regarding the use of cyclosporine A in the treatment of juvenile idiopathic arthritis associated uveitis. EULAR abstract

68.

Tappeiner C, Roesel M, Heinz C, Michels H, Ganser G, Heiligenhaus (2009) A Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis. Eye 23:1192–1198PubMedCrossRef

69.

Gerloni V, Cimaz R, Gattinara M, Arnoldi C, Pontikaki I, Fantini F (2001) Efficacy and safety profile of cyclosporin A in the treatment of juvenile chronic (idiopathic) arthritis. Results of a 10-year prospective study. Rheumatology (Oxford) 40:907–913

70.

Kotaniemi K (1998) Late onset uveitis in juvenile-type chronic polyarthritis controlled with prednisolone, cyclosporin A and methotrexat. Clin Exp Rheumatol 16:469–471PubMed

71.

Walton RC, Nussenblatt RB, Whitcup SM (1998) Cyclosporine therapy for severe sight-threatening uveitis in children and adolescents. Ophthalmology 105:2028–2034PubMedCrossRef

72.

Wittmer R (1987) Juvenile uveitis. Klin Monatsbl Augenheilk 191:332–333CrossRef

73.

Pras E, Neumann R, Zandman-Goddard G, Levy Y, Assai EL, Shoenfeld Y, Langevitz P (2004) Intraocular inflammation in autoimmune diseases. Semin Arthritis Rheum 34:602–609PubMedCrossRef

74.

Biester S, Deuter C, Michels H, Haefner R, Kuemmerle-Deschner J, Doycheva D, Zierhut M (2007) Adalimumab in the therapy of uveitis in childhood. Br J Ophthalmol 91:319–324PubMedCrossRef

75.

Godfrey WA, Epstein WV, O’Connor GR, Kimura SJ, Hogan MJ, Nozik RA (1974) The use of chlorambucil in intractable idiopathic uveitis. Am J Ophthalmol 78:415–428PubMed

76.

Palmer RG, Kanski JJ, Ansell BM (1985) Chlorambucil in the treatment of intractable Uveitis associated with juvenile chronic arthritis. J Rheumatol 12:967–970PubMed

77.

Miserocchi E, Baltatzis S, Ekong A, Roque M, Foster CS (2002) Efficacy and safety of chlorambucil in intractable noninfectious uveitis: the Massachusetts Eye and Ear Infirmary experience. Ophthalmology 109:137–142PubMedCrossRef

78.

Baltatzis S, Tufail F, Yu EN, Vredeveld CM, Foster CS (2003) Mycophenolate mofetil as an immunomodulatory agent in the treatment of chronic ocular inflammatory disorders. Ophthalmology 110:1061–1065PubMedCrossRef

79.

Doycheva D, Deuter C, Stuebiger N, Biester S, Zierhut M (2007) Mycophenolate mofetil in the treatment of uveitis in children. Br J Ophthalmol 91:180–184PubMedCrossRef

80.

Sobrin L, Christen W, Foster CS (2008) Mycophenolate mofetil after methotrexate failure or intolerance in the treatment of scleritis and uveitis. Ophthalmology 115:1416–1421PubMedCrossRef

81.

Munoz-Fernandez S, Hidalgo V, Fernandez-Melon J, Schlincker A, Bonillo G, Ruiz-Sancho D, Fonseca A, Gijon-Banos J, Martin-Mola E (2003) Sulfasalazine reduces the number of flares of acute anterior uvetiis over one year period. J Rheumatol 30:1277–1279PubMed

82.

Beritez-Del-Castillo JM, Iradier T, Banares A (2000) Sulfasalazine in the prevention of anterior uveitis associated with ankylosing spondylitis. Eye 14:340–343CrossRef

83.

Huang JL, Hung IJ, Hsieh KH (1997) Sulphasalazine therapy in chronic uveitis of children with chronic arthritis. Asian Pac J Allergy Immunol 15:71–75PubMed

84.

Heiligenhaus A, Horneff G, Greiner K, Mackensen F, Zierhut M, Foeldvari I, Michels H (2007) Inhibitors of tumour necrosis factor-alpha for the treatment of arthritis and uveitis in childhood. Klin Monatsbl Augenheilkd 224:526–531PubMedCrossRef

85.

Galor A, Perez VL, Hammel JP, Lowder CY (2006) Differential effectiveness of etanercept and infliximab in the treatment of ocular inflammation. Ophthalmology 113:2317–2323PubMedCrossRef

86.

Kahn P, Weiss M, Imundo LF, Levy DM (2006) Favorable response to high-dose infliximab for refractory childhood uveitis. Ophthalmology 113:860–864, e862

87.

Mangge H, Heinzl B, Grubbauer HM, El-Shabrawi Y, Schauenstein K (2003) Therapeutic experience with infliximab in a patient with polyarticular juvenile idiopathic arthritis and uveitis. Rheumatol Int 23:258–261PubMedCrossRef

88.

Rajaraman RT, Kimura Y, Li S, Haines K, Chu DS (2006) Retrospective case review of pediatric patients with uveitis treated with infliximab. Ophthalmology 113:308–314PubMedCrossRef

89.

Richards JC, Tay-Kearney ML, Murray K, Manners P (2005) Infliximab for juvenile idiopathic arthritis-associated uveitis. Clin Experiment Ophthalmol 33:461–468PubMedCrossRef

90.

Saurenmann RK, Levin AV, Rose JB, Parker S, Rabinovitch T, Tyrrell PN, Feldman BM, Laxer RM, Schneider R, Silverman ED (2006) Tumour necrosis factor alpha inhibitors in the treatment of childhood uveitis. Rheumatology (Oxford) 45:982–989CrossRef

91.

Sharma SM, Ramanan AV, Riley P, Dick AD (2007) Use of infliximab in juvenile onset rheumatological disease-associated refractory uveitis: efficacy in joint and ocular disease. Ann Rheum Dis 66:840–841PubMedCrossRef

92.

Tynjala P, Lindahl P, Honkanen V, Lahdenne P, Kotaniemi K (2007) Infliximab and etanercept in the treatment of chronic uveitis associated with refractory juvenile idiopathic arthritis. Ann Rheum Dis 66:548–550PubMedCrossRef

93.

Vazquez-Cobian LB, Flynn T, Lehman TJ (2006) Adalimumab therapy for childhood uveitis. J Pediatr 149:572–575PubMedCrossRef

94.

Lovell DJ, Ruperto N, Goodman S et al (2008) Adalimumab with or without methotrexate in juvenile rheumatoid arthritis. N Engl J Med 359:810–820PubMedCrossRef

95.

Foeldvari I, Nielsen S, Kummerle-Deschner J, Espada G, Horneff G, Bica B, Olivieri AN, Wierk A, Saurenmann RK (2007) Tumor necrosis factor-alpha blocker in treatment of juvenile idiopathic arthritis-associated uveitis refractory to second-line agents: results of a multinational survey. J Rheumatol 34:1146–1150PubMed

96.

Gallagher M, Quinones K, Cervantes-Castaneda RA, Yilmaz T, Foster CS (2007) Biological response modifier therapy for refractory childhood uveitis. Br J Ophthalmol 91:1341–1344PubMedCrossRef

97.

Reiff A, Takei S, Sadeghi S, Stout A, Shaham B, Bernstein B, Gallagher K, Stout T (2001) Etanercept therapy in children with treatment-resistant uveitis. Arthritis Rheum 44:1411–1415PubMedCrossRef

98.

Scrivo R, Spadaro A, Spinelli FR, Valesini G (2008) Uveitis following the use of tumor necrosis factor alpha inhibitors: comment on the article by Lim et al. Arthritis Rheum 58:1555–1556; author reply 1556–1557

99.

Smith JA, Thompson DJ, Whitcup SM, Suhler E, Clarke G, Smith S, Robinson M, Kim J, Barron KS (2005) A randomized, placebo-controlled, double-masked clinical trial of etanercept for the treatment of uveitis associated with juvenile idiopathic arthritis. Arthritis Rheum 53:18–23PubMedCrossRef

100.

Tauber T, Daniel D, Barash J, Turetz J, Morad Y (2005) Optic neuritis associated with etanercept therapy in two patients with extended oligoarticular juvenile idiopathic arthritis. Rheumatology (Oxford) 44:405CrossRef

101.

Antcliff RJ, Spalton DJ, Stanford MR, Graham EM, Fytche TJ, Marshall J (2001) Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study. Ophthalmology 108:765–772PubMedCrossRef

102.

Sallam A, Comer RM, Chang JH, Grigg JR, Andrews R, McCluskey PJ, Lightman S (2008) Short-term safety and efficacy of intravitreal triamcinolone acetonide for uveitic macular edema in children. Arch Ophthalmol 126:200–205PubMedCrossRef

103.

Roesel M, Gutfleisch M, Heinz C, Heimes B, Zurek-Imhoff B, Heiligenhaus A (2009) Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis. Eye 23:910–914PubMedCrossRef

104.

Roesel M, Gutfleisch M, Heinz C, Heimes B, Zurek-Imhoff B, Heiligenhaus A (2009) Intravitreal and orbital floor triamcinolone acetonide injections in noninfectious uveitis: a comparative study. Ophthalmic Res 42:81–86PubMedCrossRef

105.

Tynjälä P, Kotaniemi K, Lindahl P, Latva K, Aalto K, Honkanen V, Lahdenne P (2008) Adalimumab in juvenile idiopathic arthritis-associated chronic anterior uveitis. Rheumatology (Oxford) 47:339–344CrossRef

Titel: Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis
verfasst von: A. Heiligenhaus
H. Michels
C. Schumacher
I. Kopp
U. Neudorf
T. Niehues
H. Baus
M. Becker
B. Bertram
G. Dannecker
C. Deuter
I. Foeldvari
M. Frosch
G. Ganser
M. Gaubitz
G. Gerdes
G. Horneff
A. Illhardt
F. Mackensen
K. Minden
U. Pleyer
M. Schneider
N. Wagner
M. Zierhut
Publikationsdatum: 01.05.2012
Verlag: Springer-Verlag
Erschienen in: Rheumatology International / Ausgabe 5/2012
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-011-2126-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Bildnachweise

Die Leitlinien für Ärztinnen und Ärzte, Digitale Mammographien links in kraniokaudaler Projektion./© Weigel, S. et al. / all rights reserved Springer Medizin Verlag GmbH, Operation bei Blasenkrebs/© anistidesign / Fotolia, Medizinische Fachangestellte sitzt erschöpft auf der Treppe/© Courtney Haas / peopleimages.com /stock.adobe.com (Symbolbild mit Fotomodell), Mann wird von Ärztin untersucht/© Tashi-Delek, Getty Images, iStock (Symbolbild mit Fotomodellen)

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2012

Increased serum RANTES in patients with systemic lupus erythematosus

Clinical and magnetic resonance imaging findings of the temporomandibular joint and masticatory muscles in patients with rheumatoid arthritis

A case of pulmonary sarcoidosis preceding polycythemia vera with literature review

Reply to Dua SG et al.

Transient osteoporosis of the hip: successful treatment with teriparatide