title: [Anti-TNF-α in the treatment of uveitis in the Besançon Hospital].
abstract: BACKGROUND
  Noninfectious chronic uveitis is a difficult-to-treat situation in which corticosteroids, immunosuppressive agents, and more recently, anti-tumor necrosis factor (TNF)-α are used to prevent and/or reverse severe visual impairment. This single-center retrospective study was designed to assess the use (indications, efficacy, and side effects) of anti-TNF-α agents in noninfectious uveitis.
  
  
  METHODS
  Eight patients were analyzed: three children (age, 7-15 years) and five adults (age, 27-44 years). Anti-TNF-α agents were etanercept (three patients), adalimumab (four patients), and infliximab (four patients). Diagnoses were Behçet's diseases (n=3), sarcoidosis (n=1), juvenile chronic arthritis (n=2), spondyloarthropathy (n=2), one of the latter two combined with Crohn disease. In all cases, anti-TNF-α therapies were prescribed because uveitis and/or associated disease were not under control.
  
  
  RESULTS
  Adalimumab and infliximab were effective for all patients. One patient with infliximab needed to add corticosteroids and immunosuppressive agents because of relapse. Etanercept was stopped in all cases due to a lack of effectiveness or a change in indication. In all patients, anti-TNF-α agents improved uveitis and the underlying systemic disease. In children, their use improved quality of life by corticosteroid weaning. Prescriptions did not comply with regulations for three children, because of age limits (etanercept, one; adalimumab, two). No adverse event was recorded.
  
  
  CONCLUSIONS
  In this short case series, anti-TNF-α agents were effective both on uveitis and the underlying systemic disease and were well tolerated in patients with noninfectious chronic uveitis.
authors: Service des maladies infectieuses, CHU, hôpital Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon cedex, France. cdescotesgenon@chu-besancon.fr
authors: C
authors: C
authors: Fery-Blanco
authors: C
authors: C
authors: Schwartz
authors: H
authors: H
authors: Gil
authors: E
authors: E
authors: Curlier
authors: C
authors: C
authors: Prati
authors: B
authors: B
authors: Delbosc
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D000068800:Etanercept; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D014605:Uveitis / Q000188:drug therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept