title: Long-term efficacy of abatacept in pediatric patients with idiopathic uveitis: a case series.
abstract: BACKGROUND
  Non-infectious uveitis represents one of the most common causes of blindness, even at pediatric age; in particular, idiopathic chronic uveitis can pose significant difficulties during treatment, due to a partial response to TNF-α antagonists. To date, very few case series exist describing the treatment of idiopathic uveitis not adequately controlled by TNF-α antagonists. The aim of our study is to describe the role of abatacept in achieving remission in patients with idiopathic uveitis previously treated with TNF-α antagonists, and to assess how long abatacept efficacy is maintained during follow-up. The treatment's safety profile and tolerability were also specifically investigated.
  
  
  METHODS
  Three patients affected with chronic idiopathic uveitis, who have been treated with abatacept due to loss of efficacy of TNF-α antagonists, were reviewed. Details of the demographic and clinical characteristics were recorded, and a summary of the medical history was obtained. Patients were regularly reviewed in the ophthalmology and rheumatology clinics. Assessment of their ocular condition was characterized according to the Standardization of Uveitis Nomenclature (SUN) group.
  
  
  RESULTS
  In our patients, abatacept was able to induce remission and to discontinue systemic corticosteroids after a mean of 30 weeks; the drug maintained its efficacy through a long follow-up period (42, 33, and 18 months respectively), with an excellent safety profile.
  
  
  CONCLUSIONS
  Our small case series seems to suggest abatacept to be a promising therapy in children affected with chronic idiopathic uveitis not adequately controlled by TNF-α antagonists.
authors: Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy. edoardo.marrani@gmail.com.
authors: Edoardo
authors: E
authors: Marrani
authors: Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy.
authors: Valeria
authors: V
authors: Paganelli
authors: Pediatric Ophthalmology, Anna Meyer Children Hospital, Florence, Italy.
authors: Cinzia
authors: C
authors: de Libero
authors: Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy.
authors: Rolando
authors: R
authors: Cimaz
authors: Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy.
authors: Gabriele
authors: G
authors: Simonini
mesh_terms: D000069594:Abatacept / Q000627:therapeutic use*; D000293:Adolescent; D002908:Chronic Disease; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069594:Abatacept; D008727:Methotrexate
keywords: Abatacept; Biologic therapy for uveitis; Idiopathic uveitis in children; Pediatric uveitis; Uveitis treatment