ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2439

Methotrexate Failure in Pediatric Uveitis

Courtney McCracken1, Steven Yeh2, Kirsten Jenkins3, Daneka Stryker4, Steven Tommasello5, Curtis Travers1, Scott R. Lambert2, Carolyn Drews-Botsch6 and Sheila T. Angeles-Han1,2,3, 1Pediatrics, Emory University School of Medicine, Atlanta, GA, 2Ophthalmology, Emory University School of Medicine, Atlanta, GA, 3Children's Healthcare of Atlanta, Atlanta, GA, 4Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, 5University of Alabama, Birmingham, AL, 6Epidemiology, Emory University School of Public Health, Atlanta, GA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Pediatric rheumatology, treatment and uveitis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Tuesday, November 10, 2015

Session Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects Posters (ACR): Imaging and Novel Clinical Interventions

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Pediatric
uveitis can lead to ocular complications and vision loss. Treatment consists of
steroid drops, methotrexate (MTX), and anti-tumor necrosis factor (TNF) drugs. 
Only 50-75% of children respond to methotrexate.  Our aim was to describe the
use and timing of MTX and anti-TNF drugs in pediatric uveitis.

Methods: We reviewed medical
records of 104 children with pediatric uveitis. We collected demographic and
clinical data, and timing of initial MTX use and subsequent anti-TNF use
following uveitis diagnosis.  MTX failure was defined as the addition of anti-TNF
agents for the treatment of uveitis. Time to MTX failure was described using
survival analysis modeling strategies.

Results: There were 59 children
with JIA-associated uveitis (JIAU) and 45 with other forms of uveitis (U).  Of
these, 85 (82%) were treated with MTX. The majority were female (69%), Caucasian
(61%) or African American (29%). Most had anterior disease (76%), bilateral
involvement (71%), and ocular complications (65%), commonly synechiae (45%),
cataracts (40%), and macular edema (24%).  More than half (51% JIAU; 60% U) were
treated with MTX within 6 months of diagnosis.  For children with JIAU, MTX was
initiated either prior to uveitis diagnosis (27%) or within 6 months (33%).

Forty
one (48%) required the addition of anti-TNF agents for uveitis at a median of 16
months following MTX use, and 2.2 years following uveitis diagnosis. The
majority (60%) initially received infliximab, and 20% required a second
anti-TNF drug. Kaplan-Meier estimates suggest that 13% need anti-TNF agents
within 6 months of MTX treatment; 16% by 1 year; 36% by 2 years and 59% by 5
years. Data suggests that one year after MTX therapy, fewer females than males required
anti-TNF agents (8/59 (14%) vs. 6/22 (27%) p<0.1) [Figure1], and more Hispanic
children were treated with anti-TNF agents compared to non-Hispanics (4/11
(36%) vs. 10/68 (15%) p<0.1) [Figure2]. Timing of initial MTX use following
uveitis diagnosis, type of uveitis, race, ANA positivity, complications, and
age at uveitis diagnosis did not predict timing of MTX failure.

Conclusion: Most children
with uveitis require therapy beyond corticosteroid treatment.  Up to 82% are
treated with MTX within 6 months of diagnosis, and almost 50% require an anti-TNF
agent within 2.5 years of diagnosis.  One in five children are treated with a second
anti-TNF drug. Male gender and Hispanic ethnicity may be associated with severe
uveitis requiring biologic therapy.  Further elucidation of the factors
associated with severe uveitis may help with optimal early treatment of
disease.

 


Disclosure: C. McCracken, None; S. Yeh, None; K. Jenkins, None; D. Stryker, None; S. Tommasello, None; C. Travers, None; S. R. Lambert, None; C. Drews-Botsch, None; S. T. Angeles-Han, NIH NEI K23-EY021760, 2.

To cite this abstract in AMA style:

McCracken C, Yeh S, Jenkins K, Stryker D, Tommasello S, Travers C, Lambert SR, Drews-Botsch C, Angeles-Han ST. Methotrexate Failure in Pediatric Uveitis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/methotrexate-failure-in-pediatric-uveitis/. Accessed February 27, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/methotrexate-failure-in-pediatric-uveitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.