Uveitis in Children: The Role of Biological Agents in Its Management

We aimed to determine medium and long-term effects of TNF-alpha inhibitors in patients with pediatric uveitis. This was a retrospective review of medical charts. Included were 50 patients (84 eyes). Mean age at diagnosis was 7.22 +/- 4.04 years. At baseline (time of initiation of biologic therapy), all patients had active uveitis. Complete control of uveitis was achieved in 84.52% (n = 71) of eyes, after a median of 3 months (IQR 2 months). Mean LogMAR BCVA at baseline was 0.23 +/- 0.44; it remained stable at 12 and 24 months. At baseline, 64% of patients were treated with oral corticosteroids, this decreased to 29.5% at 12 months (p = 0.001) and to 21.9% at 24 months (p < 0.001). Mean time to prednisone dose of <= 0.2 mg/kg/day was 8.1 +/- 2.02 months after baseline. A total of 40.5% of eyes were treated with topical steroids at baseline and this significantly decreased to 5.8% at 12 months. Multiple linear regression model was calculated to predict moderate and severe visual loss; only presenting visual acuity accounted for a unique variance in the model. In conclusion, TNF-alpha inhibitors achieved rapid disease control while enabling a remarkable steroid-sparing effect in children suffering from chronic uveitis. Presenting visual acuity was the sole predictor of moderate to severe visual loss.

Automated summary

This retrospective study evaluated the medium and long-term effects of TNF-alpha inhibitors on pediatric uveitis. The results showed that TNF-alpha inhibitors effectively controlled the disease progression and reduced the need for steroids in children with chronic uveitis. Furthermore, the initial visual acuity was found to be a significant predictor for moderate to severe visual loss.