Original ArticleMethotrexate Therapy May Prevent the Onset of Uveitis in Juvenile Idiopathic Arthritis
Section snippets
Methods
The study was conducted by review of the charts of all consecutive patients who: (1) met the International League for Associations of Rheumatology (ILAR) criteria for JIA17; (2) were first seen at the study center between January 2002 and February 2011; (3) had a disease duration of <1 year at the first observation; (4) had a minimum follow-up duration after the first visit of 2 years; and (5) had received a stable management for at least 2 years after the first visit with either MTX, with or
Results
A total of 254 patients met the inclusion criteria and were eligible for enrollment in either of the 2 groups. These patients were part of a whole series of ∼900 patients with JIA who were seen at the study center during the study period. Table I shows the main demographic, clinical, and treatment characteristics of patients at their baseline visit. Overall, the series was overly represented by girls with early disease onset and positive ANA status.19 The majority of patients had the ILAR
Discussion
We investigated whether MTX therapy reduces the incidence of uveitis in children with JIA. The study sample was overly represented by girls with early disease onset and positive ANA status, a subset of JIA patients who have a high risk for the development of uvelitis.4 The homogeneity of the patient population was strengthened by the exclusion of children with systemic or RF-positive arthritis, who rarely experience ocular involvement, and of patients with enthesitis-related arthritis, who may
References (22)
- et al.
Systemic uveitis syndromes in childhood: an analysis of 340 cases
Ophthalmology
(1984) - et al.
Juvenile idiopathic arthritis
Lancet
(2007) - et al.
Methotrexate for resistant chronic uveitis in children with juvenile rheumatoid arthritis
J Pediatr
(1998) - et al.
International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease
Am J Ophthalmol
(1987) Uveitis in childhood: part I. Anterior
Ann Ophthalmol
(1989)- et al.
Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: a long-term followup study
Arthritis Rheum
(2007) - et al.
Time of onset of iridocyclitis (IC) in children with juvenile idiopathic arthritis (JIA)
Pediatr Rheumatol Online J
(2008) - et al.
Timing of uveitis onset in oligoarticular juvenile idiopathic arthritis (JIA) is the main predictor of severe course uveitis
Acta Ophthalmol
(2012) - et al.
Textbook of pediatric rheumatology
(2005) - et al.
Arthritis in children and adolescents
(2006)
Methotrexate in resistant juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind, placebo-controlled trial. The Pediatric Rheumatology Collaborative Study Group and The Cooperative Children's Study Group
N Engl J Med
Cited by (0)
M.B. received the Articulum Fellowships and was supported by the Ministry of Health of Czech Republic (RVO-VFN64165/2012) and Charles University (PRVOUK P24/LF1/3). The authors declare no conflicts of interest.