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10.12.2019 | Review Article

Treating juvenile idiopathic arthritis (JIA)-related uveitis beyond TNF-α inhibition: a narrative review

verfasst von: Carla Gaggiano, Donato Rigante, Gian Marco Tosi, Antonio Vitale, Bruno Frediani, Salvatore Grosso, Claudia Fabiani, Luca Cantarini

Erschienen in: Clinical Rheumatology | Ausgabe 2/2020

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Abstract

Chronic anterior uveitis is the most frequent among extra-articular manifestations of juvenile idiopathic arthritis (JIA) and a relevant cause of ocular morbidity in children. Asymmetric arthritis, early onset disease, female sex, and anti-nuclear antibody (ANA) positivity are counted among risk factors for developing this complication. It usually has insidious onset and asymptomatic chronic-relapsing course, but the persistence of low-grade chronic inflammation can lead to irreversible structural ocular damage and to vision-threatening complications. For such reasons, achieving a complete absence of inflammation through early targeted and aggressive treatments is a primary therapeutic goal in these patients. This review is aimed at summarizing scientific evidence about biologic rescue therapy of JIA-related uveitis in patients who fail to achieve clinical remission, in spite of being treated with conventional disease-modifying anti-rheumatic drugs (cDMARDs) and at least one biologic tumor necrosis factor (TNF)-α inhibitor. Interleukin (IL)-6 inhibition appears a promising and safe option for refractory JIA-related uveitis. Abatacept and rituximab proved to be beneficial as well, but their efficacy together with some safety concerns needs to be more extensively evaluated.

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Titel: Treating juvenile idiopathic arthritis (JIA)-related uveitis beyond TNF-α inhibition: a narrative review
verfasst von: Carla Gaggiano
Donato Rigante
Gian Marco Tosi
Antonio Vitale
Bruno Frediani
Salvatore Grosso
Claudia Fabiani
Luca Cantarini
Publikationsdatum: 10.12.2019
Verlag: Springer London
Erschienen in: Clinical Rheumatology / Ausgabe 2/2020
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04763-3

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