Uveitis treatment in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry: response to tumour necrosis factor inhibitors

Objective Treatment with tumour necrosis factor inhibitors (TNFi) has significantly improved outcomes in uveitis associated with juvenile idiopathic arthritis (JIA-U). This study examines a CARRA Registry cohort of JIA-U patients on TNFi to analyse utilisation patterns and identify factors associated with response. Methods This retrospective cohort study used CARRA Registry data for subjects aged 0–25 with JIA-U who had uveitis onset before the age of 19, and ever used TNFi. We collected data about demographics, uveitis courses, and treatment. We defined TNFi response and identified associated characteristics. As appropriate, comparisons between factors were tested using t-test, Chi-square, and Fisher’s exact test. Multivariable logistic regression was used to model TNFi response. Results Among 871 JIA-U subjects, 616 (70.7%) used TNFi; 558 met inclusion criteria; 418 (74.9%) had successful treatment under TNFi. Among the 140 (25.1%) TNFi non-responders, 117 remained on TNFi and 23 discontinued. Multivariate analysis found significant TNFi success associations with White race (OR=2.08, p=0.005) and non-oligoarticular JIA (OR=1.58, p=0.044). Conclusion In this CARRA Registry cohort of patients with JIA-U, a large proportion used a TNFi for uveitis. The percentage successfully treated with TNFi is consistent with the current literature. White race and non-oligoarticular JIA were associated with a successful response to TNFi.