Short report
Retrospective analysis of children with uveitis treated with infliximab

Presented at the 9th Congress of International Ocular Inflammation Society (IOIS), Paris France September, 17-20, 2007.
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Tumor necrosis factor-alpha (TNF-α) antagonists have been successfully used in refractory cases of pediatric uveitis.1, 2, 3, 4, 5, 6, 7 We report our experience with the monoclonal anti-TNF-α antibody infliximab in the treatment of uveitis in 20 children. Twenty children with noninfectious uveitis were treated with infliximab as an initial line of immunomodulatory therapy (4 children) or for uncontrolled intraocular inflammation despite aggressive immunosuppressive therapy (16 children). Intraocular inflammation was controlled in the short term in all children; resistance developed in 4 children after long-term therapy.

Section snippets

Methods

We reviewed the medical records of 20 children with uveitis who had been treated with infliximab between 2002 and 2007. The study population was obtained from the database of the Uveitis Service at the Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, including 78 children with idiopathic intermediate uveitis, 34 with juvenile idiopathic arthritis (JIA)-related uveitis, 20 with idiopathic chronic anterior uveitis, and 26 with Behçet uveitis. Inclusion criteria were

Results

Demographic features, systemic medications, and ocular complications at initiation of infliximab therapy, ocular surgeries performed after the initiation of infliximab therapy, and total number of infliximab infusions are shown in e-Supplement 1, available at jaapos.org. Thirteen patients were male (65%) and 7 were female (35%). The median age at presentation was 7.1 years (range, 3-12 years). Eight patients had idiopathic pars planitis, 7 had JIA-related anterior uveitis, 4 had idiopathic

Discussion

Several authors have reported a favorable response to infliximab therapy in children with uveitis refractory to conventional immunosuppressive therapy.1, 2, 3, 4 In studies comparing the efficacy of infliximab versus etanercept, the former was reported to be superior.5, 6, 7 In the present series, only 1 patient had received etanercept before infliximab for his rheumatic disease. Etanercept was not considered as a first line anti-TNF therapy for uveitis in any of the patients. In previous

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