Abstract
Purpose :
Evaluate the efficacy and safety of tacrolimus for the treatment of pediatric noninfectious uveitis
Methods :
Single health system, retrospective review of electronic medical records. A chart review of patients < 18 years old diagnosed with noninfectious uveitis who were intolerant to or failed conventional systemic immunosuppressants seen by Children’s Hospital Colorado Ophthalmology and Rheumatology or University of Colorado Hospital Ophthalmology between January 2014 – January 2021 was completed. The primary outcome was the incidence of improvement in inflammation. Secondary outcomes included incidence of tacrolimus treatment failure and need for dose reduction or discontinuation due to adverse effects. Descriptive statistics were used to analyze the data. This study received IRB approval.
Results :
Ten patients (40% female; mean age: 12.9 years) were included. The most common previously failed treatments were methotrexate (n = 10) and biologics (n = 4). Uveitis was secondary to systemic autoimmune diseases in 40% of patients. Tacrolimus was initiated a mean of 3.9 years after onset of uveitis with 9 patients requiring concomitant immunosuppressants. Of the 6 patients with an established goal tacrolimus trough range, 83% reached therapeutic goal at an average of 320.6 ± 205.6 days. Treatment failure requiring alternative therapies occurred in 20% of patients. Laboratory abnormalities were observed in 7 patients; however, dose reduction was only required in 3 patients with no discontinuation of therapy.
Conclusions :
In this small cohort of patients who previously failed traditional systemic immunosuppressants, it was effective in reducing inflammation in 80% of patients. Tacrolimus was generally well-tolerated and did not require discontinuation of medication.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.