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K. Quinones, T. Yilmaz, S. M. Acevedo, M. Gallagher, C. S. Foster; Biologic Agents in the Treatment of Refractory Pediatric Uveitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3910.
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To assess the efficacy and safety of various biologic agents in the treatment of noninfectious, refractory pediatric uveitis.
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.
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).
The biologic agents included in this study appear to be effective, well-tolerated, and valuable alternatives in the treatment of refractory pediatric uveitis.
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