Original articleRisk of new-onset uveitis in patients with juvenile idiopathic arthritis treated with anti-TNFα agents
Section snippets
Methods
The charts of all 1109 children with a diagnosis of JIA seen in the Rheumatology Clinic at The Hospital for Sick Children (HSC) in Toronto, Ontario, Canada, between January 1, 1996, and June 30, 2003, were reviewed for diagnosis of noninfectious uveitis and for treatment with an anti-TNFα agent (etanercept or infliximab).
We used the 1997 ILAR criteria for JIA subgroups to describe type of juvenile arthritis.2 Patients with a diagnosis before the use of the ILAR criteria were assigned to a
Results
The total cohort of patients consisted of 1109 patients, of whom 145 patients (13.1%) had development of uveitis and 87 patients (7.8%) received anti-TNFα therapy. Seventy patients were treated with an anti-TNFα agent without a prior diagnosis of uveitis (Table I). Forty-eight of the 70 patients (68.6%) were treated with etanercept, 13 of 70 (18.6%) with infliximab, and 9 of 70 (12.9%) with both etanercept and infliximab consecutively (6 with etanercept followed by infliximab and 3 with
Discussion
TNFα-blocking agents are increasingly used to treat children with JIA refractory to conventional therapy. Although most reports have demonstrated resolution of refractory uveitis with anti-TNFα, cases of new-onset uveitis or uveitis flares after initiation of anti-TNFα therapy have been reported.5, 6, 7, 8 This has led to the concern that treatment with TNFα inhibitors may lead to an increased risk for the development of uveitis in patients with JIA. In our study of a large cohort of patients
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Cited by (0)
Supported by the Swiss arthritis society (Schweizerische Rheumaliga), Stiftung Sanitas (Switzerland) and Brandan’s Eye Research Fund.