Abstract:
Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in childhood, and is associated with uveitis in up to 20-25% of cases. Typically, the uveitis is chronic, asymptomatic, non-granulomatous and anterior. For this reason, screening for uveitis is recommended to identify uveitis early and allow treatment to prevent sight-threatening complications. The management of JIA associated uveitis requires a multidisciplinary approach and a close collaboration between paediatric rheumatologist and ophthalmologist. Starting the appropriate treatment to control uveitis activity and prevent ocular complications is crucial. Current international recommendations advise a step-wise approach, starting with methotrexate and moving on to adalimumab if methotrexate alone is not sufficient to control the disease. If the uveitis remains active despite standard treatment other therapeutic options may be considered including anti-IL6 or other anti-TNF agents such as infliximab, although the evidence for these agents is limited.
摘要:
幼年特发性关节炎(JIA)是儿童时期最常见的慢性风湿性疾病,并且在高达20-25%的病例中与葡萄膜炎有关。通常,葡萄膜炎是慢性的,无症状,非肉芽肿和前。出于这个原因,建议筛查葡萄膜炎,以便及早发现葡萄膜炎,并进行治疗以预防危及视力的并发症.JIA相关葡萄膜炎的管理需要多学科方法以及儿科风湿病学家和眼科医生之间的密切合作。开始适当的治疗以控制葡萄膜炎活动并预防眼部并发症至关重要。目前的国际建议建议采取循序渐进的方法,从甲氨蝶呤开始,如果单独使用甲氨蝶呤不足以控制疾病,则继续使用阿达木单抗.如果葡萄膜炎仍然活跃,尽管有标准治疗,其他治疗选择可以考虑,包括抗IL6或其他抗TNF药物,如英夫利昔单抗,尽管这些药物的证据有限。