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Clinical Rheumatology
Published in: Clinical Rheumatology 2/2020

01-02-2020 | Uveitis | Review Article

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

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

Published in: Clinical Rheumatology | Issue 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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Metadata
Title
Treating juvenile idiopathic arthritis (JIA)-related uveitis beyond TNF-α inhibition: a narrative review
Authors
Carla Gaggiano
Donato Rigante
Gian Marco Tosi
Antonio Vitale
Bruno Frediani
Salvatore Grosso
Claudia Fabiani
Luca Cantarini
Publication date
01-02-2020
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 2/2020
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-019-04763-3

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