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JIA - Uveitis

Approximately 10-30% of children with JIA develop uveitis, which tends to affect eyes over a long time and mainly involves the front part of the eye. This can lead to visual loss, cataracts, increased pressure, and blindness.

Our stratified workstreams, including Uveitis has made important progress by seeking to explore use of clinical and/or molecular phenotypes associated with disease presentation, stage, outcomes, or treatment responses, to develop and improve individualised care.

In the early stages, there are often no symptoms, and there is currently no way to predict who will develop uveitis. There are a number of treatments for uveitis, including eye drops, immunosuppressive drugs, and steroids. 

The EATC4Children is actively engaged in investigating new treatments for uveitis.

Clinical Trials of JIA-associated uveitis led by the EATC4Childen

  • SYCAMORE Trial
  • APTITUDE Trial
  • TURTLE Trial.

The APTITUDE trial is an example of EATC4Children working in collaboration with industry to evaluate the efficacy of tocilizumab in children with JIA-associated uveitis who have had an inadequate response to anti-TNF therapy. The study also incorporated the collection of biological samples to support exploratory analyses aimed at understanding mechanisms of response and resistance to treatment.

The SYCAMORE trial is an example of EATC4Children partnering with industry to assess the effectiveness of adalimumab in combination with methotrexate for the treatment of JIA-associated uveitis. This landmark study provided the evidence base leading to the licensing of adalimumab for this indication and has informed current standards of care.

The TURTLE trial is an example of EATC4Children working with industry to trial a drug currently unlicensed in JIA-uveitis in which we incorporated collection of an associated biobank as part of the clinical trial protocol, with the aim of potentially identifying biomarkers of response / treatment failure.

CLUSTER (Childhood Arthritis and associated uveitis: stratification through endotypes and mechanism)

The CLUSTER consortium aimed to identify the best way to target the right drug to the right child at the right time in children with JIA and uveitis. The project ran between 2018 and 2024. The EATC4Children led two of its five workstreams: JIA-uveitis and Industry (Co-CI’s:M. Beresford, A. Ramanan).

The uveitis workstream was aimed at biomarker identification, differential pathomechanisms and potential targets for children responding and not responding to treatments.