BACKGROUND Despite the low prevalence of uveitis in pediatric rheumatic diseases, potential problems as well as high disease burden can complicate its management. In this review, we systematically assessed the epidemiological, etiological, and managerial aspects of uveitis in pediatric rheumatic diseases. METHODS This current study was conducted in accordance with the established methods and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). We searched the manuscript databases, including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane for all eligible studies in line with the considered keywords. We also conducted the statistical analysis using the Stata software. RESULTS Considering studies focusing on uveitis in Juvenile Idiopathic Arthritis (JIA) yielded a pooled prevalence of 11.8% (95%CI: 11.2 to 12.4%) for uveitis following JIA. In this regard, the prevalence rate of uveitis related to Behçet,s disease and Systemic Lupus Erythematosus (SLE( was estimated to be 15.0 and 0.8%, respectively. The pooled response rate to Adalimumab and Infliximab was estimated to be 68.0% (95%CI: 65.4 to 70.6%), 64.7% (95%CI: 59.8 to 69.3%), respectively. The documents for the systematical assessment of other biological medications (e.g. Tocilizumab, Daclizumab and Rituximab) were inadequate; however, the mean response rate for these drugs was 59, 75 and 80%, respectively. Our meta-analysis showed a pooled response rate of 40.0% (95%CI, 36.0% to 44.2) to Methotrexate. Significant heterogeneity and significant diffusion bias were demonstrated by reviewing studies. CONCLUSIONS The pooled prevalence of uveitis in pediatric rheumatic diseases widely varied based on the underlying disease requiring more investigations in different subtypes of rheumatic diseases. The biologic medications, especially Adalimumab are the most effective treatments for uveitis in pediatric rheumatic diseases; however, a combination of the safe, available alternatives is preferred to achieve the most desirable treatment response.

中文翻译：

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小儿风湿性疾病葡萄膜炎的流行病学和先进治疗方法：系统评价和荟萃分析。

背景技术尽管在小儿风湿性疾病中葡萄膜炎的患病率低，但是潜在的问题以及高的疾病负担会使它的管理复杂化。在这篇综述中，我们系统地评估了小儿风湿病中葡萄膜炎的流行病学，病因学和管理方面。方法本研究是根据既定方法和系统评价和荟萃分析协议（PRISMA-P）的首选报告项目进行的。我们搜索了包括Medline，Web of Knowledge，Google Scholar，Scopus和Cochrane在内的手稿数据库，以查找符合所考虑关键字的所有合格研究。我们还使用Stata软件进行了统计分析。结果考虑到针对青少年特发性关节炎（JIA）中葡萄膜炎的研究得出的合并患病率为11。JIA后发生葡萄膜炎的比例为8％（95％CI：11.2至12.4％）。在这方面，与白塞氏病和系统性红斑狼疮（SLE（）分别相关的葡萄膜炎患病率分别为15.0和0.8％。对阿达木单抗和英夫利昔单抗的合并缓解率估计为68.0％（95％ CI：65.4％至70.6％），64.7％（95％CI：59.8至69.3％），其他生物药物（例如Tocilizumab，Daclizumab和Rituximab）的系统评估文献不足；但是，平均缓解率这些药物分别为59％，75％和80％，我们的荟萃分析显示，对甲氨蝶呤的总反应率为40.0％（95％CI，36.0％到44.2），通过回顾性研究显示出显着的异质性和明显的扩散偏倚。结论小儿风湿病合并葡萄膜炎的患病率因基础疾病而异，需要对不同类型的风湿病进行更多研究。生物药物，尤其是阿达木单抗是治疗儿童风湿性疾病葡萄膜炎的最有效方法。然而，为了获得最理想的治疗效果，最好将安全，可用的替代品组合使用。