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Ophthalmology. 2006 May;113(5):860-4.e2. Epub 2006 Mar 20.

Favorable response to high-dose infliximab for refractory childhood uveitis.

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1
Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, New York 10032, USA.

Abstract

OBJECTIVE:

Uveitis in children most commonly is associated with juvenile idiopathic arthritis. In addition to topical glucocorticoids, treatment may include systemic immunosuppressive agents. Tumor necrosis factor alpha (TNF-alpha) has been implicated in the pathogenesis of uveitis; therefore, TNF-alpha blockade seems to be a reasonable therapeutic option to investigate. We report successful treatment of children with uveitis using infliximab.

STUDY DESIGN:

A retrospective study of our complete experience using infliximab for the treatment of childhood uveitis was conducted.

PARTICIPANTS:

Seventeen children (14 females, 3 males) with chronic uveitis were administered high-dose infliximab (10-20 mg/kg/dose).

MAIN OUTCOME MEASURES:

Our main outcome measure was the ability to eliminate all signs of intraocular inflammation.

RESULTS:

All 17 patients demonstrated a dramatic, rapid response, with no observed inflammation in 13 patients after the second infusion, and 4 patients requiring 3 to 7 infusions to achieve disease quiescence. Additional immunosuppressives and topical glucocorticoids were tapered when patients achieved no intraocular inflammation.

CONCLUSIONS:

In this series, high-dose infliximab was a rapidly effective, well-tolerated therapeutic agent for the treatment of chronic, medically refractory, noninfectious uveitis.

PMID:
16545455
DOI:
10.1016/j.ophtha.2006.01.005
[Indexed for MEDLINE]

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