How treatment choices influence the onset and outcomes of uveitis in juvenile idiopathic arthritis: a retrospective cohort study


Işık S., Arık S. D., Akgün Ö., Guliyeva V., Kavrul Kayaalp G., Türkmen Ş., ...More

Expert Opinion on Biological Therapy, vol.25, no.9, pp.1025-1033, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 9
  • Publication Date: 2025
  • Doi Number: 10.1080/14712598.2025.2545520
  • Journal Name: Expert Opinion on Biological Therapy
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1025-1033
  • Keywords: Adalimumab, biological agents, etanercept, juvenile idiopathic arthritis, uveitis
  • Istanbul University Affiliated: Yes

Abstract

Objectives: Uveitis is a prevalent complication of juvenile idiopathic arthritis (JIA), leading to ocular morbidity. This study aimed to evaluate uveitis frequency in JIA patients on biologics and explore the impact of biologic selection on its occurrence. Methods: Among 2,385 JIA patients reviewed, 101 patients who developed uveitis were analyzed. This patients were categorized based on their uveitis development: under methotrexate, after discontinuation of methotrexate, and under biologics. Results: Uveitis frequency among all reviewed JIA patients was 6.3%. Among those who developed uveitis while receiving biologics, 30 were on etanercept and one on infliximab at the time of onset. When the entire cohort of JIA patients treated with biologics for joint symptoms was evaluated, it was observed that out of 365 patients using etanercept, uveitis developed in 30 individuals, in one out of 39 patients using infliximab, while no cases of uveitis were observed among 285 patients using adalimumab. Conclusion: In this study we observed a larger frequency of new onset uveitis in JIA patients treated with TNF receptor fusion proteins than those treated with anti-TNF monoclonal antibodies. Monoclonal anti-TNF-α agents may remain the preferred options. This study highlights the necessity of integrating uveitis risk assessment into JIA treatment strategies.