Background Juvenile idiopathic arthritis (JIA) associated uveitis is one of the most severe comorbidities and occurs in around 10% of patients. There are currently no specific established outcome measures for JIA associated uveitis (JIAU). The SUN group made the first attempt to establish outcome measures for uveitis, which were not aimed at JIAU. Adopting part of it, we developed and proposed specific outcome measures for JIAU. Here we are presenting the results of the validation study.
Objectives To prospectively validate the proposed outcome measures, if they fulfil the expected OMERACT criteria.
Methods Patients were considered eligible, if they started a nonbiologic or biologic disease modifying agent, as indicated by active the uveitis. At baseline, follow up at 3 months and at 6 months following parameters were collected: demographics, rheumatologic assessment (JIA type, activity of arthritis, JIA-related disability), ophthalmologic assessment (duration of uveitis, activity and damage of uveitis, visual acuity, ocular complications, topical and systemic medications, surgical procedure, uveitis-related disability).
Results 49 patients were included in the study and 35 patients had a complete follow-up for at least at 6 months. 34/49 (69%) of the patients were female. The mean age at inclusion into the study was 8.4 years (SD=3.4). 98% of the patients were Caucasian. At inclusion the median disease duration of JIA was 52 months for arthritis and 33 months for uveitis. All patients had anterior uveitis. The left eye was more frequently involved (95.3%) then the right eye (81%). Cellcount at baseline was +1 or more in 65.1% of the right eyes and 68.9% of the left eyes, and at 6 months only 22.6% in the right and 19.3% in the left eyes. The cell count before dilatation (p=0.008) and after dilatation (p<0.001) improved significantly over time. Flare was ≥1+ (graded by SUN) at baseline in the right eyes in 76.7% and in the left eyes 70.2% and at 6 months at the right eyes in 24.1% and the left eyes in 24.1%. The flare grade according SUN (p<0.001) improved significantly comparing time point zero to 6 months. The VAS score (0-100) for uveitis related disability decreased from 40.8 to 17.5 (p=0.002) and JIA associated disability, decreased from 34.1 to 8.3 (p<0.001).
Conclusions These results regarding the standardized assessment of the JIAU are promising. The newly suggested Uveitis disability, cell count and flare grade showed significant changes after 6 months. Further evaluation of these items and the other suggested items will help to establish standardized measures to assess the activity of uveitis and the efficacy of a drug in treatment trials.
Disclosure of Interest None declared