Riskalla Mona M, Barbar-Smiley Fatima A, Marka Nicholas A, Lerman Melissa A
Division of Pediatric Rheumatology, Allergy and Immunology, Department of Pediatrics, University of Minnesota, MN, USA.
Amgen Inc., Thousand Oaks, CA, USA.
Clin Exp Rheumatol. 2025 May;43(5):946-952. doi: 10.55563/clinexprheumatol/08z0v4. Epub 2024 Dec 20.
Treatment with tumour necrosis factor inhibitors (TNFi) has significantly improved outcomes in uveitis associated with juvenile idiopathic arthritis (JIA-U). This study examines a CARRA Registry cohort of JIA-U patients on TNFi to analyse utilisation patterns and identify factors associated with response.
This retrospective cohort study used CARRA Registry data for subjects aged 0-25 with JIA-U who had uveitis onset before the age of 19, and ever used TNFi. We collected data about demographics, uveitis courses, and treatment. We defined TNFi response and identified associated characteristics. As appropriate, comparisons between factors were tested using t-test, Chi-square, and Fisher's exact test. Multivariable logistic regression was used to model TNFi response.
Among 871 JIA-U subjects, 616 (70.7%) used TNFi; 558 met inclusion criteria; 418 (74.9%) had successful treatment under TNFi. Among the 140 (25.1%) TNFi non-responders, 117 remained on TNFi and 23 discontinued. Multivariate analysis found significant TNFi success associations with White race (OR=2.08, p=0.005) and non-oligoarticular JIA (OR=1.58, p=0.044).
In this CARRA Registry cohort of patients with JIA-U, a large proportion used a TNFi for uveitis. The percentage successfully treated with TNFi is consistent with the current literature. White race and non-oligoarticular JIA were associated with a successful response to TNFi.
使用肿瘤坏死因子抑制剂（TNFi）进行治疗已显著改善了与青少年特发性关节炎相关的葡萄膜炎（JIA-U）的治疗效果。本研究调查了CARRA注册中心队列中接受TNFi治疗的JIA-U患者，以分析其使用模式并确定与反应相关的因素。
这项回顾性队列研究使用了CARRA注册中心的数据，研究对象为0至25岁、葡萄膜炎发病于19岁之前且曾使用过TNFi的JIA-U患者。我们收集了有关人口统计学、葡萄膜炎病程和治疗的数据。我们定义了TNFi反应并确定了相关特征。在适当情况下，使用t检验、卡方检验和Fisher精确检验对因素之间进行比较。使用多变量逻辑回归对TNFi反应进行建模。
在871名JIA-U受试者中，616名（70.7%）使用了TNFi；558名符合纳入标准；418名（74.9%）在TNFi治疗下获得成功。在140名（25.1%）TNFi无反应者中，117名继续使用TNFi，23名停药。多变量分析发现TNFi治疗成功与白种人（OR=2.08，p=0.005）和非少关节型JIA（OR=1.58，p=0.044）显著相关。
在这个CARRA注册中心的JIA-U患者队列中，很大一部分人使用TNFi治疗葡萄膜炎。TNFi治疗成功的百分比与当前文献一致。白种人和非少关节型JIA与TNFi治疗成功反应相关。
