COMBINATION FOR TREATMENT FOR UVEITIS IN CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Objective: to evaluate the efficacy of combination therapy of children with uveitis associated with juvenile idiopathic arthritis, resistant to standard local and systemic therapy with corticosteroids and methotrexate. Materials and methods. We examined 36 children with juvenile idiopathic arthritis, treated in the pediatric and ophthalmology departments of the clinic of Saint-Petersburg state pediatric medical University in 2009-2016 Age of the patients ranged from 4 to 14 years. Before monitoring begins, all patients received regular therapy regarding arthritis with the use of methotrexate for at least two years. When joining the uveitis treatment was added gradually at first, local corticosteroids by injection and instillation of dexamethasone. With no effect or in case of severe course of uveitis added systematically adalimumab. Evaluated the effectiveness of combination therapy for duration of remission, the frequency of exacerbations and severity of uveitis. Results. Using only locally dexamethasone remission of active uveitis occurred an average of 4 weeks, and on the background of adalimumab treatment was achieved after an average of 2 weeks from the start of treatment. The duration of remission of uveitis also increased when using adalimumab in an average of 28 weeks. Marked reduction in the frequency of exacerbations of uveitis: 4 cases per patient in the year before the appointment of adalimumab to 0 on the background of its application. Conclusions. The staged treatment of uveitis associated with Jia, from the local instillation of dexamethasone to the use of adalimumab, may be used to achieve long-term remission and prevent complications (bibliography: 9 refs).

adalimumab, juvenile idiopathic arthritis, methotrexate, uveitis