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Mitul C. Mehta, Sarah Lopper, Daniel Ash, Daniel J. Lovell, Adam Kaufman; Long Term Efficacy of Infliximab in the Treatment of Pediatric Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4259.
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In this study we present five pediatric patients with combined anterior and intermediate uveitis who have been well controlled on infliximab for an average of 4.2 years.
We reviewed the ophthalmology charts of children at Cincinnati Children’s Hospital Medical Center (CCHMC) and the Uveitis service at the University of Cincinnati Department of Ophthalmology (UC) who were started on infliximab between October 1, 2002 and June 1, 2009, and identified all of the patients who remained on infliximab for greater than 2 years. Uveitis was graded according to the Standardization of Uveitis Nomenclature (SUN) Working Group classification system. A total of 9 patients met the entrance criteria, 4 had combined anterior and intermediate uveitis, 2 had juvenile idiopathic arthritis (JIA) associated anterior uveitis, and 3 had idiopathic anterior uveitis not associated with arthritis.
Four of the 9 patients were eventually switched to adalimumab. One of those patients was switched due to eventual loss of efficacy of infliximab, two patients were switched for financial reasons, and one patient was switched due to adverse effects. The remaining 5 patients, all are well controlled (1/2+ or less cell in the worse eye) on infliximab, on steroid eye drops not more than four times per day, with or without weekly methotrexate for a mean of 4.22 years with a standard deviation of 1.65 years. Four of those 5 patients were diagnosed with combined anterior and intermediate uveitis, and the other patient had only anterior uveitis associated with JIA.
The potential loss of efficacy of infliximab for the treatment of uveitis has been previously described. In this series, we have shown that infliximab can be effective for long term treatment of combined anterior and intermediate uveitis in children.
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