Risk Factors Associated with the Relapse of Uveitis in Patients with Juvenile Idiopathic Arthritis

Abstract Purpose:To identify risk factors associated with relapse of uveitis in patients with juvenile idiopathicarthritis (JIA) - associated chronic or recurrent uveitis following treatment with immunomodulatorytherapy (IMT) and a drug free remission of 1 year.Methods:Retrospective chart review of 30 patients with JIA associated uveitis, who were successfullytreated with IMT to a state of corticosteroid-free remission, and subsequently remained in remissionfollowing discontinuation of IMT for a period of at least 1 year. In subsequent follow up, some patientshad relapse of uveitis while others continued to be in remission. Remission was defined as <1+ cells in theanterior chamber or vitreous. Relapse was defined as 1+ cells in the anterior chamber or vitreous. Wecompared patients in remission with those who relapsed, in an effort to evaluate risk factors associatedwith the relapse.Results:Out of 30 patients, 17 (56.7%) remained in remission while 13 (43.3%) relapsed. The patients inthe remission group received IMT earlier (median of 9 months, inter-quartile range [IQR] 6-12 months) inthe 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 hadreceived treatment with IMT at a younger age (median age 6 years, IQR 4-9 years) as compared to therelapse group (median age 11years, IQR 8-15 years) (Mann-Whitney test, p = 0.04). None of the otherfactors studied revealed significant association with the relapse of uveitis.Conclusions:Patients with uveitis associated with JIA treated with IMT earlier in the course of disease