Risk of new-onset uveitis in patients with juvenile idiopathic arthritis treated with anti-TNFα agents

ObjectiveTo determine whether treatment with tumor necrosis factor alpha (TNFα)–blocking agents alters the incidence of new-onset uveitis in patients with juvenile idiopathic arthritis (JIA).Study designCohort study based on retrospective chart review. The charts of all 1109 patients with a diagnosis of JIA seen between January 1, 1996, and June 30, 2003, at our clinic were reviewed for diagnosis of uveitis and treatment with TNFα inhibitors. Cox regression analysis was performed with anti-TNFα treatment as a time-dependent covariate for risk of development of uveitis.ResultsWe identified 70 patients treated with anti-TNFα without a prior diagnosis of uveitis. Two of these 70 patients (2.9%), both treated with etanercept, had development of new-onset uveitis during anti-TNFα therapy. One had juvenile psoriatic arthritis diagnosed 4.1 years before onset of uveitis. The other had extended oligoarticular JIA diagnosed 6.4 years before onset of uveitis. We found no statistically significant difference in the risk for development of uveitis between patients with or without anti-TNFα treatment.ConclusionsIn our patients with JIA, anti-TNFα treatment did not alter the risk for development of new-onset uveitis. However, anti-TNFα therapy with etanercept did not prevent the development of uveitis in 2 patients.