Saeed Muhammad Usman, Raza Syed Hamid, Goyal Sudeshna, Cleary Gavin, Newman William David, Chandna Arvind
Ophthalmology Department, Alder Hey Children's Hospital, Alder Hey Children's NHS Foundation Trust .
Semin Ophthalmol. 2014 Jan;29(1):1-3. doi: 10.3109/08820538.2013.839802. Epub 2013 Oct 31.
We report our results with systemic Etanercept in patients with juvenile idiopathic arthritis in a joint ophthalmology-rheumatology clinic at a tertiary hospital.
Patients with JIA on Etanercept were identified from a dedicated uveitis database. A retrospective review of electronic and paper-based patient records was performed.
Nine patients with JIA and current or previous treatment with Etanercept were identified, including six females and three males. Five patients with previous or current uveitis were noted. A further four were under observation for uveitis and required Etanercept for their joint disease. All nine patients had previously been taking Methotrexate, which had a suboptimal response in controlling arthritis or uveitis. Six out of nine patients did not show any uveitis activity at their last follow-up. Eyes of three patients still show signs of active inflammation in the anterior chamber (two on Etanercept and one off Etanercept). Severely impaired visual acuity (PL) was recorded in both eyes of one patient with long-standing persistent uveitis. Moderate visual loss in one eye of one patient was seen. The remaining seven patients did not show any significant loss of vision. Intraocular inflammation was not induced in any patient started on Etanercept.
Etanercept may be useful in controlling JIA-related uveitis or arthritis in a pediatric patient when Methotrexate has had a suboptimal response in controlling the inflammatory activity.
我们报告了在一家三级医院的眼科 - 风湿病联合诊所中，使用全身性依那西普治疗青少年特发性关节炎患者的结果。
从一个专门的葡萄膜炎数据库中识别出接受依那西普治疗的青少年特发性关节炎患者。对电子和纸质患者记录进行回顾性审查。
确定了9名接受依那西普当前或既往治疗的青少年特发性关节炎患者，其中包括6名女性和3名男性。记录到5名患者有既往或当前葡萄膜炎。另有4名患者因葡萄膜炎正在接受观察，且其关节疾病需要依那西普治疗。所有9名患者此前都在服用甲氨蝶呤，但在控制关节炎或葡萄膜炎方面效果欠佳。9名患者中有6名在最后一次随访时未表现出任何葡萄膜炎活动迹象。3名患者的眼睛在前房仍显示有活动性炎症迹象（2名正在使用依那西普，1名未使用依那西普）。1名患有长期持续性葡萄膜炎的患者双眼视力严重受损（仅存光感）。1名患者一只眼睛有中度视力丧失。其余7名患者未出现任何明显的视力丧失。开始使用依那西普的患者均未诱发眼内炎症。
当甲氨蝶呤在控制炎症活动方面效果欠佳时，依那西普可能有助于控制儿科患者与青少年特发性关节炎相关的葡萄膜炎或关节炎。
