Abstract
Purpose::
To assess the efficacy and safety of various biologic agents in the treatment of noninfectious, refractory pediatric uveitis.
Methods::
All pediatric patients treated with a biologic agent for their uveitis were identified. Main outcome measures included the quantitative measurement of intraocular inflammation, corticosteroid-sparing effects of the agent, and changes in visual acuity.
Results::
Twenty five patients (46 eyes) with refractory uveitis were identified. The biologics, used adjunctively with immunomodulating agents in 23 patients, included Daclizumab (n=3), Adalimumab (n=7), and Infliximab (n=15). The mean follow-up time for treatment was 8, 11, and 13 months, respectively. Diagnosis of the participants included: juvenile idiopathic arthritis with uveitis (n=20), two with idiopathic anterior uveitis, and one patient each with Adamantiades-Behcet Disease, sarcoid associated uveitis, and idiopathic panuveitis. There was evidence of decreased intraocular inflammation in 92% of patients. The remaining 8% of subjects maintained their initial presentation. This finding correlated with a reduction in the use of topical and/or systemic corticosteroids. With regard to visual acuities, there was an overall improvement in 76% while 20% remained stable. Therapy was generally well tolerated, except in one patient who developed respiratory distress and had to discontinue the agent (Infliximab).
Conclusions::
The biologic agents included in this study appear to be effective, well-tolerated, and valuable alternatives in the treatment of refractory pediatric uveitis.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • inflammation • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials