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Ujwala H. Baheti, Alaa Radwan, Cheryl Arcinue, Ravi Parikh, Ashik Mohamed, C Stephen Foster; Risk Factors Associated with the Relapse of Uveitis in Patients with Juvenile Idiopathic Arthritis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6252.
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To identify risk factors associated with relapse of uveitis in patients with juvenile idiopathic arthritis (JIA) - associated chronic or recurrent uveitis following treatment with immunomodulatory therapy (IMT) and a drug free remission of 1 year.
Retrospective chart review of 30 patients with JIA associated uveitis, who were successfully treated with IMT to a state of corticosteroid-free remission, and subsequently remained in remission following discontinuation of IMT for a period of at least 1 year. In subsequent follow up, some patients had relapse of uveitis while others continued to be in remission. Remission was defined as <1+ cells in the anterior chamber or vitreous. Relapse was defined as ≥ 1+ cells in the anterior chamber or vitreous. We compared patients in remission with those who relapsed, in an effort to evaluate risk factors associated with the relapse.
Out of 30 patients, 17 (56.7%) remained in remission while 13 (43.3%) relapsed. The patients in the remission group received IMT earlier (median of 9 months, inter-quartile range [IQR] 6-12 months) in the course of disease from diagnosis as compared to patients in the relapse group (median of 78 months, IQR 36-120 months) (Mann-Whitney test, p = 0.0004). Moreover, the patients in the remission group had received treatment with IMT at a younger age (median age 6 years, IQR 4-9 years) as compared to the relapse group (median age 11years, IQR 8-15 years) (Mann-Whitney test, p = 0.04). None of the other factors studied revealed significant association with the relapse of uveitis.
Patients with uveitis associated with JIA treated with IMT earlier in the course of disease and at a younger age have less likelihood of relapse of the uveitis following discontinuation of the IMT after a 2 year period of quiescence on IMT.
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