Methotrexate Monotherapy in Juvenile Idiopathic Arthritis Associated Uveitis: Myth or Reality?. (17th November 2022)

• Record Type: Journal Article
• Authors: Tirelli, Francesca; Zannin, Maria Elisabetta; Vittadello, Fabio; Agnolucci, Jacopo; Mazzarolo, Monica; Zulian, Francesco
• Is Part Of: Ocular immunology and inflammation. Volume 30:Number 7/8(2022)
• Page Start: 1763
• Page End: 1767
• Publication Date: 2022-11-17
• Subjects: Methotrexate -- uveitis -- juvenile idiopathic arthritis -- outcome; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2021.1951303
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Objective: To evaluate the long-term efficacy of methotrexate (MTX) monotherapy in patients with juvenile idiopathic arthritis-associated uveitis (JIA-U). Methods: We analyzed a cohort of patients with JIA-U treated with MTX monotherapy, divided into two groups depending on whether MTX was started before (on-MTX group) or after uveitis diagnosis (MTX-naïve group). The primary endpoint was the time between uveitis inactivity and first relapse. Results: 84 patients entered the study. The median duration of remission on MTX monotherapy resulted 8.2 months. The on-MTX group showed a significant longer time interval between arthritis and uveitis onset and higher need for biologic agents (bDMARD). During follow-up, 40 patients (47.6%) needed bDMARD due to poor control of uveitis. Clinical remission off medication was achieved in 11.9% of patients, all belonging to the MTX-naïve group. Conclusions: MTX monotherapy, although effective in early stages of JIA-U, showed poor disease control in the long term.