Clinical Rheumatology

, Volume 32, Issue 11, pp 1673–1675 | Cite as

Leflunomide, a valid and safe drug for the treatment of chronic anterior uveitis associated with juvenile idiopathic arthritis

  • Clara MolinaEmail author
  • Consuelo Modesto
  • Nieves Martín-Begué
  • Cristina Arnal
Brief Report


Chronic anterior uveitis (CAU) is an important extra-articular manifestation of juvenile idiopathic arthritis (JIA).

Although the incidence of serious sight loss varies between series (6–25 %), CAU related to JIA (CAUJIA) is an important cause of blindness in children from developed countries [1, 2]. The severity of the complications obliges the use of prompt, aggressive treatment to prevent sequelae. In an attempt to spare glucocorticoids and avoid side effects, various immunosuppressive drugs have been used. Leflunomide (LFN) has proven to be safe and effective long-term therapy for the articular component of JIA [3]. To our knowledge, there is no available information about the efficacy of LFN in CAUJIA.

Materials and methods

A retrospective, observational study was performed to evaluate the efficacy and safety of LFN in the treatment of CAUJIA. Thirteen patients with CAU from our cohort of 417 children with JIA, all of whom had received LFN for at least 7 months to...


Juvenile Idiopathic Arthritis Uveitis Leflunomide Juvenile Idiopathic Arthritis Patient Severe Vision Loss 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors have not received financial support or any other benefits from commercial sources for the work reported in the manuscript. The authors declare no conflicts of interest with regard to the work (Clara Molina, none; Consuelo Modesto, none; Nieves Martín-Begué, none; and Cristina Arnal, none).


  1. 1.
    Sabri K, Saurenmann RK, Silverman ED et al (2008) Course, complications, and outcome of juvenile arthritis-related uveitis. J AAPOS 12:539–545PubMedCrossRefGoogle Scholar
  2. 2.
    Dana MR, Merayo-Lloves J, Schaumberg DA et al (1997) Visual outcomes prognosticators in juvenile rheumatoid arthritis-associated uveitis. Ophthalmology 104:236–244PubMedCrossRefGoogle Scholar
  3. 3.
    Silverman E, Mouy R, Spiegel L et al (2005) Leflunomide or methotrexate for juvenile rheumatoid arthritis. N Engl J Med 352:1655–1666PubMedCrossRefGoogle Scholar
  4. 4.
    Petty RE, Southwood TR, Manners P et al (2004) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision. J Rheumatol 31:390–392PubMedGoogle Scholar
  5. 5.
    Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516PubMedCrossRefGoogle Scholar
  6. 6.
    Prakash A, Jarvis B (1999) Leflunomide: a review of its use in active rheumatoid arthritis. Drugs 58:1137–1164PubMedCrossRefGoogle Scholar
  7. 7.
    Parikh JG, Tawansy KA, Rao NA (2008) Immunohistochemical study of chronic nongranulomatous anterior uveitis in juvenile idiopathic arthritis. Ophthalmology 115:1833–1836PubMedCrossRefGoogle Scholar
  8. 8.
    Robertson SM, Lang LS (1994) Leflunomide: inhibition of S-antigen induced autoimmune uveitis in Lewis rats. Agents Actions 42:167–172PubMedCrossRefGoogle Scholar
  9. 9.
    Simonini G, Cantarini L, Bresci C et al (2010) Current therapeutic approaches to autoimmune chronic uveitis in children. Autoimmun Rev 9:674–683PubMedCrossRefGoogle Scholar
  10. 10.
    Yu EN, Meniconi ME, Tufail F et al (2005) Outcomes of treatment with immunomodulatory therapy in patients with corticosteroid-resistant juvenile idiopathic arthritis-associated chronic iridocyclitis. Ocul Immunol Inflamm 13:353–360PubMedCrossRefGoogle Scholar
  11. 11.
    Foeldvari I, Wierk A (2005) Methotrexate is an effective treatment for chronic uveitis associated with juvenile idiopathic arthritis. J Rheumatol 32:362–365PubMedGoogle Scholar
  12. 12.
    Heiligenhaus A, Mingels A, Heinz C et al (2007) Methotrexate for uveitis associated with juvenile idiopathic arthritis: value and requirement for additional anti-inflammatory medication. Eur J Ophtalmol 17:743–748Google Scholar
  13. 13.
    Tappeiner C, Roesel M, Heinz C et al (2009) Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis. Eye (Lond) 23:1192–1198CrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Clara Molina
    • 1
    Email author
  • Consuelo Modesto
    • 2
  • Nieves Martín-Begué
    • 3
  • Cristina Arnal
    • 2
  1. 1.Rheumatology DepartmentHospital Universitario y Policlínico La FeValenciaSpain
  2. 2.Rheumatology DepartmentHospital Universitario Vall HebronBarcelonaSpain
  3. 3.Ophthalmology DepartmentHospital Universitario Vall HebronBarcelonaSpain

Personalised recommendations