Methotrexate Monotherapy in Juvenile Idiopathic Arthritis Associated Uveitis: Myth or Reality?

Figures & data

Table 1. Demographic and clinical characteristics of the patients.

	On-MTX N = 16	MTX-naïve N = 68	p
Female gender	14 (87.5)	57 (83.8)	>.999
Age at JIA diagnosis (years)	3.8 (1.8–4.6)	2.6 (1.9–4.4)	.770
Age at uveitis diagnosis (years)	6.0 (3.3–8.2)	3.5 (2.6–5.7)	.009
Time interval between arthritis and uveitis diagnosis (years)*	1.9 (0.5–4.5)	0.3 (0–1.26)	< .001
MTX treatment duration prior to uveitis onset (months)	16.7 (5.5–45.2)	-	-
Time between uveitis onset and MTX starting (months)	-	9 (2.1–24)	-
Age at MTX starting	4.1 (2.1–5.1)	4.9 (3.2–7.3)	.043
Ocular complications at the last evaluation
Patients with at least one complication at MTX starting	1 (6.3)	19 (27.9)	.07
Patients with at least one new complication on MTX Posterior Synechiae Band Keratopathy Cataract Increased IOP Decreased IOP CMO	5 (31.3) 3 (18.8) 1 (6.3) 2 (12.5) 2 (12.5) 0 (0) 0 (0)	17 (25.0) 5 (7.4) 6 (8.8) 8 (11.8) 8 (11.8) 1 (1.5) 2 (2.9)	.61 .16 .74 .93 .9--
MTX treatment outcomes at the last evaluation
Clinical inactivity on medication	4 (25)	13 (23.6)	.60
Duration of remission (months)	9.2 (4.4–14.16)	7.8 (4.4–20.1)	.31
MTX monotherapy duration (months)	16.5 (11.4–33.8)	37.9 (22.4–69.1)	.013
Need for bDMARD	12 (75%)	28 (41%)	.015

Quantitative variables were expressed as median (IQR), qualitative variables as number (%), unless otherwise specified.

*Eight patients, all from the MTX-naïve group, were excluded from this analysis since uveitis developed before the onset of JIA.

Legend: JIA, Juvenile Idiopathic Arthritis; MTX, Methotrexate; IOP, Intraocular Pressure, CMO, Cystoid Macular Edema; bDMARD = biologic agents.

Figure 1. Kaplan-Meier survival estimates of the time to the first Anterior Uveitis relapse in MTX-naive and on-MTX groups (p 0.61, log rank test).

Figure 2. Disposition of the patients Values are expressed as number (%) Captions: MTX, Methotrexate; AU, Anterior Uveitis; CIM, Clinical Inactivity on Medication, CR, Clinical Remission off medication.