The role of biologic response modifiers in the management of juvenile idiopathic arthritis associated uveitis: a review

ABSTRACT

Juvenile idiopathic arthritis (JIA) is the most common childhood systemic disease associated with uveitis and significantly detracts from the child’s quality of life. Due to the high rate of ocular morbidities in JIA associated uveitis, the main treatment goal remains the complete elimination of active inflammation at all times. An aggressive ‘step-ladder’ approach starting with conventional immunotherapy is usually tried initially in order to control the ocular inflammation. For those who fail conventional therapy, biologic response modifiers have been shown to be effective in controlling the inflammation. Available data demonstrate the extensive and successful, yet off-label, use of biologic agents in the treatment of refractory JIA associated uveitis especially in cases that fail or deemed intolerant to conventional immunosuppressive therapy. In this review, we discuss different biologic response modifiers; their applications in the treatment of JIA associated uveitis and their safety profile in general.

KEYWORDS:

• Juvenile idiopathic arthritis
• uveitis
• JIA associated uveitis
• biologics
• treatment

Acknowledgements

The authors acknowledge Halea Meese, M.S. for her editorial assistance.

Declaration of interest

C.S Foster is a consultant for Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA), Eyegate Pharma (Waltham, MA), Novartis (Cambridge, MA), pSivida (Watertown, MA) and Xoma (Berkeley, CA) and has received grants or grants pending with Alcon (Aliso Viejo, CA), Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb Surgical, Inc (Bridgewater, NJ), Clearside Biomedical (Alpharetta, GA), Dompé pharmaceutical (Milan, Italy), Eyegate Pharma (Waltham, MA), Mallinckrodt Pharmaceuticals (Dublin Ireland), Novartis Pharmaceuticals (Cambridge, MA), pSivida (Watertown, MA), Santen (Osaka, Japan). C.S Foster has received payment for lectures including service on speaking bureaus from Alcon (Aliso Viejo, CA), Allergan (Dublin, Ireland) and has stock or stock options in Eyegate Pharma (Waltam, MA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.