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

Le résumé fourni par la source

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

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