{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T06:48:30Z","timestamp":1785739710363,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Objective<\/jats:title>\n Treatment of childhood chronic idiopathic uveitis (cCIU) is predominantly based on studies in juvenile idiopathic arthritis\u2013associated uveitis and expert opinion. Our aim was to report the treatment outcomes of our cohort of cCIU.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Retrospective multicenter study involving the rheumatology and ophthalmology units at Florence, Italy, and Bristol, United Kingdom. We included children with cCIU, who received at least one systemic treatment. Ocular inflammation and treatment response were assessed according to the standardized uveitis nomenclature.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 116 patients with cCIU received at least one systemic treatment (93 methotrexate, 22 adalimumab, and 1 mycophenolate), whereas 60 of them received an additional second\u2010line treatment (45 adalimumab, 14 mycophenolate, and 1 tocilizumab). Children treated with adalimumab (plus or minus methotrexate) as a first\u2010line therapy were more likely to achieve remission than methotrexate alone (\u03c7\n 2<\/jats:sup>\n = 31.35;\n P<\/jats:italic>\n < 0.001); furthermore, children treated with methotrexate as a first\u2010line therapy relapsed earlier (\u03c7\n 2<\/jats:sup>\n = 4.35;\n P<\/jats:italic>\n = 0.043). Children receiving adalimumab were more likely to stop treatment for remission than methotrexate (\u03c7\n 2<\/jats:sup>\n = 25.9;\n P<\/jats:italic>\n < 0.001). Regarding second\u2010line therapy, children who started adalimumab (plus or minus methotrexate) were more likely to achieve remission than mycophenolate (\u03c7\n 2<\/jats:sup>\n = 14.66;\n P<\/jats:italic>\n = 0.005). Children with nonanterior uveitis, conversely to the others, were more likely to achieve remission with adalimumab as a first\u2010line therapy than methotrexate (\u03c7\n 2<\/jats:sup>\n = 32.3;\n P<\/jats:italic>\n < 0.001). Children with nonanterior uveitis, but not children with anterior uveitis, were more likely to stop the first\u2010line treatment when receiving adalimumab than methotrexate (\u03c7\n 2<\/jats:sup>\n = 18.56;\n P<\/jats:italic>\n = 0.001) due to persistent remission.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Adalimumab shows promise as a potential first\u2010line therapy for cCIU, particularly for posterior segment uveitis. Although effective in anterior uveitis, methotrexate leads children to relapse earlier than adalimumab.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/art.70090","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T07:31:16Z","timestamp":1770708676000},"page":"1789-1797","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of a Large Cohort of Childhood Chronic Noninfectious Uveitis in a Multicentric Large Study: Adalimumab Versus Methotrexate as First\u2010Line Therapy"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6418-3254","authenticated-orcid":false,"given":"Ilaria","family":"Maccora","sequence":"first","affiliation":[{"name":"Pediatric Rheumatology Unit Meyer Children's Hospital IRCCS Florence Italy"},{"name":"NeuroFARBA Department University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Guly","sequence":"additional","affiliation":[{"name":"Bristol Eye Hospital Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"de Libero","sequence":"additional","affiliation":[{"name":"Pediatric Ophthalmology Unit Meyer Children's Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Carreras","sequence":"additional","affiliation":[{"name":"Biostatistic Unit Meyer Children's Hospital IRCCS Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athimalaipet V.","family":"Ramanan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rheumatology Bristol Royal Hospital for Children Bristol United Kingdom"},{"name":"Translational Health Sciences University of Bristol Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Simonini","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology Unit Meyer Children's Hospital IRCCS Florence Italy"},{"name":"NeuroFARBA Department University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2024.101979"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.03.057"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2021.03.061"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2023.2198210"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.14175"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24963"},{"issue":"6","key":"e_1_2_7_8_1","first-page":"864","article-title":"2019 American College of Rheumatology\/Arthritis Foundation guideline for the screening, monitoring, and treatment of juvenile idiopathic arthritis\u2010associated uveitis","volume":"71","author":"Angeles\u2010Han ST","year":"2019","journal-title":"Arthritis Care Res 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