Abatacept in the treatment of severe, longstanding, and refractory uveitis associated with juvenile idiopathic arthritis.

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  • Additional Information
    • Source:
      Publisher: Journal Of Rheumatology Publishing Co Country of Publication: Canada NLM ID: 7501984 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0315-162X (Print) Linking ISSN: 0315162X NLM ISO Abbreviation: J Rheumatol Subsets: MEDLINE
    • Publication Information:
      Publication: Toronto : Journal Of Rheumatology Publishing Co
      Original Publication: Toronto.
    • Subject Terms:
      Abatacept/*therapeutic use ; Arthritis, Juvenile/*complications ; Immunosuppressive Agents/*therapeutic use ; Uveitis/*drug therapy; Adolescent ; Child ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Uveitis/complications
    • Abstract:
      Objective: Abatacept (ABA), a selective T cell costimulation modulator that binds to CD80 and CD86 on antigen-presenting cells, was investigated for its antiinflammatory effect in treating severe chronic uveitis associated with juvenile idiopathic arthritis (JIA).
      Methods: Our retrospective study was conducted by members of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC). Patients with JIA who are receiving ABA treatment for active uveitis were included. In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, immunosuppressives, and at least 1 tumor necrosis factor-α inhibitor. A standardized protocol was used to document uveitis (MIWGUC) and arthritis. Baseline visit and visits at 3, 6, 9, and 12 months before and after ABA start were evaluated. Primary outcome measure was defined as achievement of uveitis inactivity; secondary outcome measures were tapering of corticosteroid and/or immunosuppressive treatment, and occurrence of complications.
      Results: In all, 21 patients (16 female) with active uveitis (n = 21) and arthritis (n = 18) were included (mean age 11.8 ± 3.6 yrs). In 7 of 18 patients with active arthritis at baseline, inactivity was achieved following ABA treatment. Uveitis inactivity was achieved in 11 patients, but recurred later in 8 of them, and remained active in another 10 cases. Systemic corticosteroids or immunosuppression were tapered in 3 patients, but uveitis recurred in all of them during further followup. Ocular complications secondary to uveitis were present in 17 patients at baseline, while 3 patients developed new ocular complications during followup.
      Conclusion: A sustained response to ABA was uncommon in patients with severe and refractory uveitis.
    • Contributed Indexing:
      Keywords: ABATACEPT; BIOLOGICALS; JUVENILE IDIOPATHIC ARTHRITIS; UVEITIS
    • Accession Number:
      0 (Immunosuppressive Agents)
      7D0YB67S97 (Abatacept)
    • Publication Date:
      Date Created: 20150203 Date Completed: 20151223 Latest Revision: 20220321
    • Publication Date:
      20221213
    • Accession Number:
      10.3899/jrheum.140410
    • Accession Number:
      25641892