Adalimumab therapy for refractory childhood uveitis.

Abstract

PURPOSE:

To report the results of adalimumab therapy in a cohort of children with refractory noninfectious uveitis.

METHODS:

The medical records of patients diagnosed with uveitis and treated with biweekly adalimumab injections for a period of at least 3 months at the University Hospital of La Paz from 2007-2012 were retrospectively reviewed. Improvement in inflammatory activity was graded according to grading schema of the Standardization of Uveitis Nomenclature Working Group.

RESULTS:

A total of 15 patients participated in the study (12 girls; mean patient age, 12 years). Diagnoses included juvenile idiopathic arthritis in 10 patients, idiopathic uveitis in 4, and familial juvenile systemic granulomatosis or Blau syndrome in 1. Mean follow-up was 32 months (median, 36; range, 15-58 months). Improvement in inflammatory activity was initially observed in 12 (86%) of 14 children, with a mean time to achieve response of 6 weeks (median, 4; range, 1-18). Treatment was effective in 9 patients (60%), mildly effective in 2 (13%), ineffective in 2 (13%), and resulted in worsening in 2 (13%). In the juvenile idiopathic arthritis patients, response was effective in 6 cases (60%), mildly effective in 2 (20%), and ineffective in 2 (20%). Adalimumab therapy was discontinued in 4 patients.

CONCLUSIONS:

Adalimumab was effective in most patients in the initial control of acute inflammatory activity in children with refractory uveitis, although therapy appears to become less effective in the long term.

• Authors: Luciano Bravo-Ljubetic, Jesús Peralta-Calvo, Susana Noval, Natalia Pastora-Salvador, José Abelairas-Gómez, Rosa Merino
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 17 Issue 5 Pg. 456-9 (Oct 2013) ISSN: 1528-3933 [Electronic] United States
• PMID: 24160962 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal, Humanized
• Tumor Necrosis Factor-alpha
• Adalimumab

Topics

• Adalimumab
• Adolescent
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Child
• Child, Preschool
• Female
• Humans
• Male
• Retrospective Studies
• Severity of Illness Index
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Uveitis (drug therapy)