title: Adalimumab therapy for refractory childhood uveitis.
abstract: OBJECTIVE
  To report the results of adalimumab therapy in a cohort of children with refractory noninfectious uveitis.
  
  
  METHODS
  The medical records of patients diagnosed with uveitis and treated with biweekly adalimumab injections for a period of at least 3 months at the University Hospital of La Paz from 2007-2012 were retrospectively reviewed. Improvement in inflammatory activity was graded according to grading schema of the Standardization of Uveitis Nomenclature Working Group.
  
  
  RESULTS
  A total of 15 patients participated in the study (12 girls; mean patient age, 12 years). Diagnoses included juvenile idiopathic arthritis in 10 patients, idiopathic uveitis in 4, and familial juvenile systemic granulomatosis or Blau syndrome in 1. Mean follow-up was 32 months (median, 36; range, 15-58 months). Improvement in inflammatory activity was initially observed in 12 (86%) of 14 children, with a mean time to achieve response of 6 weeks (median, 4; range, 1-18). Treatment was effective in 9 patients (60%), mildly effective in 2 (13%), ineffective in 2 (13%), and resulted in worsening in 2 (13%). In the juvenile idiopathic arthritis patients, response was effective in 6 cases (60%), mildly effective in 2 (20%), and ineffective in 2 (20%). Adalimumab therapy was discontinued in 4 patients.
  
  
  CONCLUSIONS
  Adalimumab was effective in most patients in the initial control of acute inflammatory activity in children with refractory uveitis, although therapy appears to become less effective in the long term.
authors.affiliation: Service of Ophthalmology, Instituto de Investigación Hospital Universitario La Paz (IdiPaz), Hospital Universitario La Paz, Madrid, Spain. Electronic address: Labravol@uc.cl.
authors.forename: Luciano
authors.initials: L
authors.lastname: Bravo-Ljubetic
authors.forename: Jesús
authors.initials: J
authors.lastname: Peralta-Calvo
authors.forename: Susana
authors.initials: S
authors.lastname: Noval
authors.forename: Natalia
authors.initials: N
authors.lastname: Pastora-Salvador
authors.forename: José
authors.initials: J
authors.lastname: Abelairas-Gómez
authors.forename: Rosa
authors.initials: R
authors.lastname: Merino
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab