Golimumab for the treatment of refractory juvenile idiopathic arthritis-associated uveitis

Juvenile idiopathic arthritis (JIA)-associated uveitis is a potentially blinding disease and accounts for up to 75 % of all pediatric anterior uveitis cases in many tertiary care referral centers [1]. Inability to control ocular inflammation in pediatric uveitis can lead to complications such as cataracts, macular edema, band keratopathy, and glaucoma leading to vision loss [1]. Off-label use of biologic response modifiers such as tumor necrosis factor alpha (TNFα) inhibitors, including infliximab, adalimumab, and etanercept, have expanded the treatment armamentarium for refractory JIA-associated uveitis. A cross-sectional survey by Foeldvari et al. demonstrated that TNF inhibitors were effective in two thirds of patients with JIA-associated uveitis who did not respond to conventional immunosuppressive agents [2]. Golimumab (GLM) is a novel fully humanized anti-TNFα monoclonal antibody that has been approved for the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis [3]. We present three cases of refractory JIA-associated uveitis treated with GLM. Institutional review board approval for this case series was waived by the Massachusetts Eye and Ear Infirmary Human Studies Committee.