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10-04-2018 | Article

Editorial board commentary

Sangeeta Sule

Comment on: Recommendations for managing JIA-associated uveitis published

The investigators in this study undertook a daunting task: to provide recommendations for the diagnosis and treatment of juvenile idiopathic arthritis (JIA)-associated uveitis. The authors performed a thorough systematic review to identify relevant articles/studies to help guide their recommendations.

For me as a pediatric rheumatologist, there were multiple take-away points. The most important point that the authors stressed is that there needs to be effective communication between rheumatology and ophthalmology to ensure that these children are screened and treated appropriately. This sounds very simple, but in this day and age of “go-go-go,” it can be difficult to find time.  Electronic medical records have made communication easier, but directly speaking about a patient can lead to better understanding for providers and their patients.

Another important take-away point for me was the length of time needed to treat. The recommendations noted that patients should be treated for 2 years of inactive disease off topical steroids before reducing systemic immunosuppression. This recommendation is especially helpful to counsel patients and their families to be patient and allow their bodies to recover from the inflammation before trying to taper.

The other points stressed by the authors are the lack of data in JIA associated uveitis.  The authors note that for some of the recommendations, the level of evidence was low. This highlights the need for further research and investment of time and resources into JIA associated uveitis, one of the most common reasons for vision loss in the pediatric population.

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