Immunomodulatory therapy with tumour necrosis factor α inhibitors in children with antinuclear antibody-associated chronic anterior uveitis: long-term results. Issue 4 (23rd January 2014)

• Record Type: Journal Article
• Authors: Doycheva, Deshka; Zierhut, Manfred; Blumenstock, Gunnar; Stuebiger, Nicole; Januschowski, Kai; Voykov, Bogomil; Deuter, Christoph
• Is Part Of: British journal of ophthalmology. Volume 98:Issue 4(2014)
• Page Start: 523
• Page End: 528
• Publication Date: 2014-01-23
• Subjects: Inflammation; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2013-303935
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aim: The aim of the study was to assess the long-term efficacy and tolerability of tumour necrosis factor α (TNFα) inhibitors in the therapy of children with refractory antinuclear antibody (ANA)-associated chronic anterior uveitis. Methods: Retrospective analysis of 31 children with ANA-associated uveitis, treated with TNFα inhibitors with a follow-up period of at least 2 years. The outcome measures included: control of inflammation, corticosteroid-sparing potential and side effects. Results: Twenty-three children (74%) were treated with adalimumab, five children (16%) with infliximab and three children (10%) with etanercept. Control of uveitis, defined as 0 anterior chamber cells while on ≤2 drops/day topical corticosteroids, was achieved in 22 of 31 patients (71%) after 1 year (95% CI 52% to 86%), and in 21 of 29 patients (72%) after 2 years of treatment (95% CI 53% to 87%). Control of uveitis was observed in 18 of 23 children (78%) treated with adalimumab, and in two of five children (40%) treated with infliximab. In all children treated with etanercept, no sufficient inflammatory control was found. Systemic corticosteroids could be discontinued in 71% (12/17 children) and topical corticosteroids in 55% (17/31) of the patients. Treatment-related side effects were found in nine children (29%, rate: 0.10/patient-year). Conclusions: Our data show that adalimumab and infliximab have beneficial effects in the therapy of severe ANA-associated anterior uveitis in children.