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Experimental Autoimmune Uveitis: An Intraocular Inflammatory Mouse Model
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Managing juvenile idiopathic arthritis-associated uveitis
Madeleine J Hawkins1, Andrew D Dick2, Richard J W Lee2
1Retinal Treatment and Research Unit, Bristol Eye Hospital, Bristol, UK.
Survey of Ophthalmology
|November 25, 2015
Summary
Juvenile idiopathic arthritis-associated uveitis is challenging to manage and often asymptomatic. Anti-tumor necrosis factor-α therapies show promise for refractory cases, with newer biologics considered for treatment resistance.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Bilateral chronic anterior uveitis is a common extra-articular manifestation of juvenile idiopathic arthritis (JIA).
- Uveitis affects 11-13% of JIA patients, particularly females with oligoarthritis and antinuclear antibodies.
- This condition often presents insidiously and asymptomatically, complicating early diagnosis and management.
Purpose of the Study:
- To review the current understanding and management strategies for JIA-associated uveitis.
- To evaluate the efficacy and safety of biologic therapies in refractory JIA uveitis.
- To highlight the role of anti-tumor necrosis factor-α agents and emerging biologics.
Main Methods:
- Review of existing literature on JIA-associated uveitis.
- Analysis of evidence from small-scale studies and clinical practice regarding immunomodulatory therapies.
- Consideration of data from ongoing randomized control trials for biologic agents.
Main Results:
- Stepwise immunomodulatory therapy is the standard approach for JIA-associated uveitis.
- Anti-tumor necrosis factor-α therapies (infliximab, adalimumab) demonstrate promising results in refractory cases.
- Newer biologics (rituximab, tocilizumab, etc.) are being investigated for cases resistant to anti-TNF-α therapy.
Conclusions:
- Managing JIA-associated uveitis is challenging due to potential refractoriness to traditional treatments.
- Biologic therapies, particularly anti-TNF-α agents, represent a significant advancement in treating refractory JIA uveitis.
- Ongoing research and trials are crucial for optimizing treatment strategies and exploring novel therapeutic options.
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