Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
J Clin Pharm Ther. 2019 Jun;44(3):482-485. doi: 10.1111/jcpt.12821. Epub 2019 Feb 27.
Low-grade evidence supports the use of newer biologics for otherwise refractory juvenile idiopathic arthritis (JIA)-associated uveitis, such as tocilizumab.
This report details the cases of two adolescents whose severe JIA-associated uveitis was unresponsive to the first-line therapeutic approach. Tocilizumab therapy led to the remission of uveitis after a mean time of 3 weeks, and methotrexate was safely discontinued 1.5 years later.
To our knowledge, these are the first reports of successful methotrexate withdrawal during tocilizumab treatment of JIA-associated uveitis. The administration of tocilizumab without methotrexate could be considered in patients with JIA-associated uveitis unresponsive to conventional therapy.
低质量证据支持使用新型生物制剂治疗其他难治性幼年特发性关节炎（JIA）相关性葡萄膜炎，如托珠单抗。
本报告详细介绍了两名青少年的病例，他们的严重 JIA 相关性葡萄膜炎对一线治疗方法无反应。托珠单抗治疗平均 3 周后导致葡萄膜炎缓解，1.5 年后安全停用甲氨蝶呤。
据我们所知，这些是在 JIA 相关性葡萄膜炎中使用托珠单抗治疗成功停用甲氨蝶呤的首批报告。对于对常规治疗无反应的 JIA 相关性葡萄膜炎患者，可以考虑不使用甲氨蝶呤而给予托珠单抗。
