Biologic therapy in juvenile idiopathic arthritis-associated uveitis: Does it make a difference?

Objective: Juvenile idiopathic arthritis (JIA) is the most common pediatric rheumatic disease, and uveitis is its most frequent extraarticular complication. Despite advances in management, uveitis remains a major cause of morbidity. The aim of this study was to evaluate the demographic, clinical, laboratory, and treatment characteristics of patients with JIA-associated uveitis (JIA-U), with a focus on the impact of biologic therapies and potential risk factors for ocular complications. Material and Methods: This single-center retrospective cohort study included 49 JIA-U patients followed among 550 JIA cases at Ankara Etlik City Hospital (October 2022–November 2023). Demographics, laboratory parameters, clinical features, and treatment outcomes were collected. Patient characteristics were compared according to biologic therapy use and presence of ocular complications. Results: The prevalence of uveitis was 8.9%. The mean age was 12.8±4.5 years; 61.2% were female. Oligoarticular JIA was the most frequent subtype (57.1%). Uveitis was asymptomatic in 81.6% of patients, and ocular complications occurred in 34.6%. All patients received methotrexate; 67% required biologic therapy, with adalimumab as the first-line agent. At last follow-up, 84% were in remission, 8% had active disease, and 8% were in drug-free remission. No significant differences were found between groups with or without biologic therapy or ocular complications. Conclusion: Biologic therapies, particularly adalimumab, are effective in managing JIA-U, but their benefits may not be universal. Early diagnosis, regular ophthalmologic screening, and close collaboration between pediatric rheumatologists and ophthalmologists remain essential to reduce complications and improve outcomes.