Aktuelle Leitlinie zur Therapie der Uveitis bei juveniler idiopathischer Arthritis

Zusammenfassung

Zielsetzung: Aktualisierung der bestehenden deutschsprachigen interdisziplinären Leitlinie zur Therapie der juvenilen idiopathischen Arthritis (JIA)-assoziierten Uveitis aufgrund der aktuellen Literatur.

Material und Methoden: Die Leitliniengruppe bestand aus Delegierten der Deutschen Ophthalmologischen Gesellschaft, der Gesellschaft für Kinder- und Jugendrheumatologie, der Deutschen Gesellschaft für Rheumatologie, des Berufsverbandes der Augenärzte Deutschlands und Patientenvertretern. Die Methodik umfasste eine systematische Literaturrecherche, eine Graduierung von Evidenz und Empfehlungen, eine Konsensusfindung mittels nominalem Gruppenprozess und Delphirunden und eine externe Begutachtung.

Ergebnisse: Entsprechend dem individuellen Schweregrad der Uveitis kann eine qualitative hochwertige Versorgung der Patienten erzielt werden. Berücksichtigung finden Kortikosteroide, konventionell synthetische (cs) und biologische (b) disease-modifying anti-rheumatic drugs (DMARDs), einschließlich TNF-α-Inhibitoren (z. B. Adalimumab, Golimumab, Infliximab), Tocilizumab, Abatacept und Rituximab.

Schlussfolgerungen: Mit der Leitlinie wird ein aktueller Therapiealgorithmus mit Darstellung als Flussdiagramm erarbeitet.

Summary

Goal: Revision of the German interdisciplinary guideline on the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis with appreciation of recently published data.

Material and methods: The guideline group comprised delegates from German Ophthalmological Society, Society for Child and Adolescent Rheumatology, German Society of Rheumatology, Professional Association of Ophthalmologists, and patient representatives. Methods included systematic literature survey, gradation of evidence and recommendations, consensus process (Delphi procedure), and external review.

Results: Adjusted to disease severity in the individual case, a high-quality patient care can be ensured. Corticosteroids, conventional synthetic (cs) and biological (b) disease-modifying anti-rheumatic drugs (DMARDs) are taken into account, including TNFα inhibitors (e. g. adalimumab, golimumab, infliximab), tocilizumab, abatacept and rituximab.

Conclusions: Within the guideline, a current treatment algorithm with presentation as flow diagrams is established.

Schlüsselwörter

Juvenile idiopathische Arthritis - Therapie - Uveitis

Keywords

Juvenile idiopathic arthritis - treatment - uveitis

^* Leitliniengruppe: Heiligenhaus A^a, Minden K^b, Tappeiner C^a, Baus H^e, Bertram B^c, Deuter C^a, Foeldvari I^b, Föll D^b, Frosch M^b, Ganser G^b, Gaubitz M^d, Günther A^b, Heinz C^a, Horneff G^b, Huemer C^b, Kopp I^f, Lommatzsch C^a, Lutz T^b, Michels H^b, Neß T^a, Neudorf U^b, Pleyer U^a, Schneider M^d, Schulze-Koops H^d, Thurau S^a, Zierhut M^a, Lehmann HW^b.

Leitlinie der Deutschen Ophthalmologischen Gesellschaft (DOG)^a und der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)^b unter Mitwirkung folgender Fachgesellschaften: Berufsverband der Augenärzte (BVA)^c, Deutsche Gesellschaft für Rheumatologie (DGRh)^d, Patientengruppe an Uveitis erkrankter Kinder und deren Familien^e, AWMF^f.

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