The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Manifestations of JIA: JIA-Associated Uveitis, sJIA & Lung Involvement in sJIA

Manifestations of JIA: JIA-Associated Uveitis, sJIA & Lung Involvement in sJIA

July 16, 2021 • By Jason Liebowitz, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

PRSYM—At the virtual 2021 Pediatric Rheumatology Symposium (PRSYM), three speakers discussed JIA-associated uveitis, systemic JIA (sJIA) and pulmonary involvement in sJIA.

You Might Also Like
  • Adalimumab for JIA-Associated Uveitis: 5-Year Follow-up
  • Adalimumab + Methotrexate Effective for Uveitis in JIA
  • New Guideline Recommends Frequent Monitoring & Collaboration for JIA-Associated Uveitis Management
Explore This Issue
August 2021
Also By This Author
  • Dendritic Cells as Therapeutics: The New Frontier

Eyes

Mindy Lo, MD, PhD, assistant professor of pediatrics at Harvard Medical School and director of the pediatric rheumatology fellowship training program at Boston Children’s Hospital, began the session by discussing guidelines for screening for JIA-associated uveitis.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

The ACR guideline published in 2019 notes that patients who were identified as high risk for uveitis include those with anti-nuclear antibodies (ANAs), who had JIA onset prior to age 7 and a disease duration of less than or equal to four years.1 European guidelines from the Single Hub and Access Point for Pediatric Rheumatology in Europe (SHARE) indicate that, although several screening protocols have been published, no evidence exists that any one protocol is superior to another.2 Thus, the exact method for screening for uveitis may not be of utmost importance. What is essential is thinking to screen for this condition in a systematic manner.

Dr. Lo said disease activity in patients with JIA can be a relevant marker of potential ophthalmologic involvement. In a study of 98 patients with JIA-associated uveitis followed over the course of six years, researchers found a 73% concordance between active uveitis and arthritis. This finding indicates that arthritis activity in patients with JIA should prompt evaluation of uveitis activity.3

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Regarding treatment, Dr. Lo stated a three-month benchmark is important in several respects. First, if steroid treatment alone does not result in uveitis inactivity within three months or if there is reactivation of inflammation with steroid tapering during this interval, systemic immunosuppression, such as with a tumor necrosis factor (TNF) α inhibitor, is warranted. Second, in cases in which cataract surgery is indicated, it’s important to achieve at least three months of uveitis inactivity prior to surgery.

With respect to treatment options, a number of mostly retrospective studies indicate that adalimumab may lead to higher rates of remission and lower rates of relapse of JIA-associated uveitis than infliximab. With regard to treatments beyond TNF inhibitors, options may include tocilizumab and abatacept. Janus kinase inhibitors, such as baricitinib, are currently under investigation as possible treatments for JIA-associated uveitis.

When to stop treatment is a question many rheumatologists face when caring for patients with JIA-associated uveitis. In a study of 98 patients with JIA-associated uveitis, factors associated with achieving uveitis inactivity included JIA onset at older than 4 years, uveitis onset at older than 5 years and adalimumab use. Although no specific laboratory parameters were predictive of achieving uveitis inactivity, decreasing arthritis activity was associated with uveitis inactivity.4

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Systemic Disease

In the next portion of the session, Michael Ombrello, MD, tenure-track investigator, Translational Genetics and Genomics Unit, Pediatric Translational Research Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Bethesda, Md., discussed systemic JIA (sJIA). This condition manifests with a chronic inflammatory arthritis and fever, plus at least one of the following: salmon pink rash, generalized lymphadenopathy, organomegaly or serositis.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Meeting Reports Tagged With: eyes, JIA-associated uveitis, juvenile idiopathic arthritis (JIA), lungs, Pediatric Rheumatology, Pediatric Rheumatology Symposium, PRSYM, sJIA, sJIA-associated lung diseaseIssue: August 2021

You Might Also Like:
  • Adalimumab for JIA-Associated Uveitis: 5-Year Follow-up
  • Adalimumab + Methotrexate Effective for Uveitis in JIA
  • New Guideline Recommends Frequent Monitoring & Collaboration for JIA-Associated Uveitis Management
  • Aggressive Treatment of Inflammation Prevents Vision Loss in Patients with JIA-related Uveitis

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)