Marelli Luca, Romano Micol, Pontikaki Irene, Gattinara Maurizio Virgilio, Nucci Paolo, Cimaz Rolando, Miserocchi Elisabetta
Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, Milan, Italy.
Pediatric Rheumatology Unit, Azienda Socio-Sanitaria Territoriale (ASST) G. Pini-Centro Traumatologico Ortopedico (CTO), Milan, Italy.
Front Pediatr. 2021 Jun 28;9:682327. doi: 10.3389/fped.2021.682327. eCollection 2021.
To describe demographic, clinical and therapeutic findings of a large cohort of patients with JIA-associated uveitis in a nationwide referral pediatric rheumatology and uveitis center in Northern Italy. Retrospective study of 125 patients with JIA-associated uveitis followed from 2009 to 2019. Demographic and rheumatologic features including JIA ILAR classification, age at onset, and laboratory data were recorded. Ocular findings collected were: anatomic location of uveitis, laterality, type, recurrence rate, visual acuity, ocular complications, and local therapy. Systemic therapy with conventional and biologic immunosuppressants, occurrence of adverse events, and duration of treatments were recorded. One hundred and twenty-five patients with JIA-associated uveitis were followed for a meantime of 9.2 (±1.7) years. Oligoarticular JIA was present in 92.8% of patients and anterior uveitis in 96%. The most common ocular complications recorded in our sample were posterior synechiae (37.6%), cataract (20.8%), band keratopathy (19.2%), glaucoma (7.2%), and macular edema (5.6%). Conventional immunosuppressants were used in 75.2% of patients with a mean duration of 9.1 years (±5.4), while biologics were administered in 47.2% of them for a period of 5.4 years. Adverse events (AE) were seen in 23% of patients being treated with Methotrexate, in 10.4% of patients treated with Adalimumab, in 38.5% of patients in therapy with Infliximab, and in 14.3% of patients being treated with Tocilizumab. No AE were reported in patients treated with Golimumab, Certolizumab, Abatacept and Rituximab. An aggressive treatment approach for patients with JIA-associated uveitis ensured a low number of ocular complications with a good safety profile.
描述意大利北部一家全国转诊的儿科风湿病和葡萄膜炎中心一大群幼年特发性关节炎（JIA）相关葡萄膜炎患者的人口统计学、临床和治疗结果。对2009年至2019年随访的125例JIA相关葡萄膜炎患者进行回顾性研究。记录人口统计学和风湿病学特征，包括JIA国际风湿病联盟（ILAR）分类、发病年龄和实验室数据。收集的眼部检查结果包括：葡萄膜炎的解剖位置、单侧或双侧、类型、复发率、视力、眼部并发症和局部治疗。记录使用传统和生物免疫抑制剂的全身治疗、不良事件的发生情况以及治疗持续时间。125例JIA相关葡萄膜炎患者的随访时间平均为9.2（±1.7）年。92.8%的患者为少关节型JIA，96%的患者为前葡萄膜炎。在我们的样本中记录的最常见眼部并发症是后粘连（37.6%）、白内障（20.8%）、带状角膜病变（19.2%）、青光眼（7.2%）和黄斑水肿（5.6%）。75.2%的患者使用传统免疫抑制剂，平均持续时间为9.1年（±5.4），而47.2%的患者使用生物制剂，持续时间为5.4年。使用甲氨蝶呤治疗的患者中有23%出现不良事件，使用阿达木单抗治疗的患者中有10.4%出现不良事件，使用英夫利昔单抗治疗的患者中有38.5%出现不良事件，使用托珠单抗治疗的患者中有14.3%出现不良事件。使用戈利木单抗、赛妥珠单抗、阿巴西普和利妥昔单抗治疗的患者未报告不良事件。对JIA相关葡萄膜炎患者采取积极的治疗方法可确保眼部并发症数量较少且安全性良好。
