THE DECREASING PREVALENCE OF JUVENILE RHEUMATOID ARTHRITIS ASSOCIATED UVEITIS SECONDARY TO NAPROXEN

Pediatric Rheumatology Online Journal → June 2003 → Non-steroidal anti-inflammatory drugs→ Abstract #42

P. H. Pepmueller,¹ U. Daud,¹ D. H. Lee,² B. V. Davitt,² T. L. Moore.¹

^{1^{Pediatric Rheumatology, Saint Louis University, St. Louis, MO;
²Pediatric Ophthalmology, Saint Louis University, St. Louis, MO}}

Objective: We looked at the prevalence of uveitis in our patients with juvenile rheumatoid arthritis (JRA) and sought any correlation between uveitis and the use of non-steroidal anti-inflammtory drugs (NSAIDs).
Methods: The charts of 230 patients diagnosed with JRA between 1992 and 1999 were retrospectively reviewed. NSAID use and relevant data including anti-nuclear antibody (ANA) titers and the presence of rheumatoid factor (RF) was noted. All patients underwent full ophthalmologic examination.
Results: Seventeen patients (7.4%) were found to have uveitis. Treatment with naproxen was documented in 156/230 (67.8%) of patients. 47/230 (20.4%) were on other NSAIDs and 27/230 (11.7%) were not on any NSAID. Uveitis developed in 5/156 (3.2%) of patients on naproxen, 8/47 (17.0%) on other NSAIDS, and 4/27 (14.8%) of patients not on any NSAID. The odds ratio for patients to develop uveitis while on naproxen was 0.17 (p0.001) and 3. 97 on other NSAIDs. Complications were noted in 4/17 (23.5%) of patients.
Conclusions: The results of this study are consistent with recent reports of decreased prevalence of uveitis in JRA. Our results also suggest that naproxen might have a unique protective effect in preventing uveitis in JRA that is not evident with other NSAIDS. However, severe visually disabling complications may still occur. Lengthened screening intervals should be viewed cautiously. The possible protective role of naproxen needs to be futher studied.