TNF inhibitors for the long-term management of juvenile idiopathic arthritis associated uveitis: real-life data from the ITHACA cohort.

OBJECTIVES

We assess prescription patterns and describe the long-term real-life effectiveness of different TNF inhibitors (TNFis) in juvenile idiopathic arthritis-related uveitis (JIA-U).

METHODS

Patients with JIA-U treated with TNFi were retrospectively enrolled.

RESULTS

Ninety-six JIA-U patients (77% female) with an age at diagnosis of 2.44 [interquartile range (IQR) 1.56-3.81] and a median follow-up of 19 years were included. Adalimumab was the most frequently prescribed TNFi (61%), followed by etanercept (19%), infliximab (15%), and golimumab (5%). Overall, adalimumab showed the lowest complication rate (51%; p < 0.001) and median number of uveitis relapse (1; IQR 0-2; p = 0.012). Conversely, etanercept showed the highest median number of uveitis relapses (4; IQR 1-5). The cumulative incidence curves for 'uveitis relapse' were similar among TNFi. Conversely, when 'treatment change' was considered as the event, a significantly higher risk for patients treated with infliximab compared with those receiving adalimumab emerged (HR 3.06, 95% CI 1.41-6.63; p < 0.01).

CONCLUSIONS

All TNFis appear to be effective for long-term management of JIA-U. We observed some differences in the number of uveitis relapses and ocular complication rates favoring adalimumab over infliximab and etanercept, findings that need to be further confirmed in prospective studies.