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Predictors of Relapse after Discontinuing Systemic Treatment in Childhood Autoimmune Chronic Uveitis
Gabriele Simonini1,2, Claudia Bracaglia3,4, Marco Cattalini3,4
1From the Rheumatology Unit, Anna Meyer Children's Hospital-NEUROFARBA Department, University of Florence; Ophthalmology Unit, Anna Meyer Children's Hospital, Florence; Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome; Pediatric Immunology and Rheumatology Unit, Brescia; Institute of Child Health and Maternal Health IRCCS Burlo Garofolo; University of Trieste, Trieste, Italy. gabriele.simonini@unifi.it.
Objective:
To identify clinical predictors of relapse in childhood autoimmune chronic uveitis after stopping systemic treatment.
Methods:
A retrospective, multicenter, cohort study.
Results:
Ninety-four children in remission, receiving no treatments and with at least a 6-month followup, were enrolled. A higher probability of maintaining remission after discontinuing treatment was shown in idiopathic compared with juvenile idiopathic arthritis uveitis (Mantel-Cox chi-square = 23.21) if inactivity had been obtained within 6 months from starting systemic treatment (Mantel-Cox chi-square = 24.17) and by antitumor necrosis factor-α treatment (Mantel-Cox chi-square = 6.43).
Conclusion:
Type of disease, time, and type of systemic therapy to achieve inactivity predict different duration of uveitis remission after treatment withdrawal.