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Elisabetta Miserocchi, Giulio Modorati, Irene Pontikaki, Valeria Gerloni, Francesco Bandello; Rituximab Treatment For Juvenile Idiopathic Arthritis Associated Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4253.
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© ARVO (1962-2015); The Authors (2016-present)
To retrospectively evaluate the efficacy of Rituximab (an anti-CD 20 B cell monoclonal antibody) on patients with juvenile idiopathic arthritis (JIA)-associated uveitis who failed to respond to TNFα blockers.
Retrospective study. Eight patients (14 eyes) with JIA associated uveitis who had an inadequate response in controlling uveitis to one or more TNF blockers (Etanercept, Infliximab, Adalimumab) received Rituximab therapy. Rituximab was given at the dose of 1000 mg per infusion on days 1, 15 and recall 3rd and 4th infusions were at 12th and 21 months. Data collected: JIA category, age at onset of uveitis and arthritis, characteristics of the uveitis, previous systemic immunosuppressants, local corticosteroids, number and dosage of Rituximab infusions, follow-up. We evaluated: decrease in uveitis activity, visual acuity, reduction of concomitant local and systemic corticosteroid and/or immunosuppressants, occurrence of adverse events.
2 males, 6 females with a mean age of 20.26 ± 6.6 (SD) years (range: 13-34) were treated. The mean age at onset of arthritis was 2.8 ± 2.4 (SD) years; the mean age at onset of uveitis was 4.1±3.9 (SD) years; the mean ocular disease duration was 16.12 years (range 11-26 years). The mean follow-up time on Rituximab was 14.87 ± 7.1 (SD) months (range: 7-25). Four out of eight patients underwent the 3rd Rituximab recall infusion, and one patient underwent the 4th recall infusion. At last visit seven out of eight patients achieved complete control of the uveitis and were on persistent clinical remission. The decrease in uveitis activity was evident around the 4th-5th month after the first infusion. No serious adverse events occurred. Four and five patients were able to discontinue respectively systemic steroids and systemic immunosuppresants at last visit.
Rituximab may be a promising treatment option for refractory uveitis associated to JIA particularly those who have not previously responded to TNF-blockers.
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