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Title

Juvenile idiopathic arthritis and uveitis in children: new perspectives in treatment.

Purpose	Chronic anterior uveitis is the most common extra-articular manifestation associated with juvenile idiopathic arthritis (JIA). Early diagnosis and adequate treatment are primordial in the prevention of complications and in the reduction of the disease burden of JIA-associated uveitis. However to date no consensus about a standardized treatment approach exists. We conducted a literature study in search of the most recent advances in the treatment of JIA associated uveitis.
Methods	This literature study was performed at the University Hospitals of Leuven, Gasthuisberg. The search was conducted using the Medline database (PubMed). Including only English articles with a pediatric study population, published between 2015 and the 4th of February 2018, 109 articles were found. After reviewing these publications, 38 articles were withheld.
Results	Current treatment is based on a step-up approach. Consensus is reached regarding the use of corticosteroids as initial treatment for acute inflammation control. However new evidence suggests an advantage of a faster transition to steroid sparing agents. In the next step, Methotrexate remains the disease modifying anti-rheumatic drug of first choice. The introduction of biological agents has opened new perspectives in the treatment of patients resistant to conventional therapy. Different studies have already proven the efficiency of Adalimumab and infliximab in the treatment of JIA-associated uveitis. Moreover, concomitant use of Methotrexate reduced the risk of relapse.
Conclusion	The arrival of the biologicals (adalimumab, infliximab) has opened new perspectives in the treatment of JIA-associated uveitis resistant to conventional therapy, consisting of steroids supplemented by Methotrexate.
Conflict of interest	No

Authors 1

Last name	BERTELOOT
Initials	S
Department	KUL
City	Leuven

Authors 2

Last name	Casteels
Initials	I
Department	UZL
City	Leuven

Authors 3

Last name	Wouters
Initials	C
Department	UZL
City	Leuven