My daughter is 11yrs old and was diagnosed with pauci JRa at age 3. It soon became extended oligoarthritis with uveitis. Her arthritis is mostly inactive on the meds. We have treated her uveitis for 7 years now. Her meds have been Mtx, pred forte, and homatropine along with (not together but in this order) Enbrel, Remicade, and Humira. She has had eye injections, band keratopathy removal, and cataract surgery on one eye and is beginning to form one in the other eye. She is not a steroid responder and her pressures remain low (4 - 6) while in a flare. Her eyes are hazy, her pupils stick, and she is at times an anomaly in dr.'s offices.
She had great results on Remicade which brought her down to one pred drop a day for several months. She then started making antibodies to it so we switched to Humira. At the same time her liver enzymes were raised because of the mtx so they dropped it back to 15mg from 20mg.
Unfortunately, our planned move came due and we now have a new medical team. This year on Humira has been nearly as bad as the first years after diagnosis. She has flared at least 4 times in the last 8mos and this current flare is proving to be tougher then most. The new dr.s raised her mtx back to 20mg and want to begin abatacept (Orencia).
What would you recommend? Is there any evidence that Orencia will/can help with uveitis? I have been reading this forum and uveitis.org but I still have a lot to learn about which options/medications may be recommended or available to her.
Thank you for your help and time.