Objective: This study aimed to investigate the underlying causes of relapse and to assess treatment outcomes in children with juvenile idiopathic arthritis (JIA)-associated uveitis who were managed with systemic disease-modifying antirheumatic drugs (DMARDs) and biologic therapies. Material and Methods: Medical records of 41 pediatric patients diagnosed with JIA-associated uveitis between January 2018 and January 2024 were retrospectively reviewed. Demographic features, clinical characteristics, therapeutic changes, and remission durations were analyzed and compared before and after treatment adjustments. Results: Relapse occurred most frequently due to inadequate dosing (56.1%). Adjustments to therapy included dose escalation, addition of new agents, or switching to alternative medications. Following these modifications, the mean remission interval increased significantly (17.61 months vs. 10.00 months, p=0.011). Among biologics, infliximab usage rose markedly after treatment modification (p=0.039). The most common ocular complications were posterior synechiae (65.9%) and elevated intraocular pressure (36.6%). Conclusion: Our findings suggest that tailoring biologic selection and adjusting dosages according to individual patient response are essential strategies for managing refractory JIA-associated uveitis. Infliximab proved to be an effective option in cases unresponsive to conventional regimens. Careful monitoring, timely escalation of therapy, and a personalized approach may help prevent vision-threatening outcomes. Future prospective multicenter studies with larger cohorts are required to validate these observations and to inform standardized long-term treatment protocols.
Koçkar et al. (Thu,) studied this question.