Favorable Response to High-Dose Infliximab for Refractory Childhood Uveitis

Ophthalmology. 2006 May;113(5):860-4.e2. doi: 10.1016/j.ophtha.2006.01.005. Epub 2006 Mar 20.

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.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal / administration & dosage*
  • Antirheumatic Agents / administration & dosage*
  • Arthritis, Juvenile / complications
  • Child
  • Chronic Disease
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Infliximab
  • Infusions, Intravenous
  • Male
  • Retrospective Studies
  • Sarcoidosis / complications
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / immunology
  • Uveitis / drug therapy*
  • Uveitis / etiology
  • Uveomeningoencephalitic Syndrome / complications

Substances

  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab