title: Treatment of pediatric uveitis with adalimumab: the MERSI experience.
abstract: OBJECTIVE
  To evaluate adalimumab therapy in children with uveitis.
  
  
  METHODS
  The electronic health records of pediatric patients diagnosed with uveitis and treated with adalimumab therapy were reviewed retrospectively. Demographic information, site and degree of intraocular inflammation, visual acuity, underlying systemic disorders, duration of therapy, side effects, and ability to obtain steroid-free remission were recorded.
  
  
  RESULTS
  A total of 17 patients were included, 16 patients with anterior uveitis and 1 with panuveitis; 14 patients had bilateral disease. Juvenile idiopathic arthritis had been diagnosed in 14 patients, sarcoidosis in 1 patient, and idiopathic etiology in 2 patients. Of the 17 patients, 13 (about 77%) achieved steroid-free remission, and 4 did not. Six patients flared after discontinuation of adalimumab, with evidence of inflammation noted 3-7 months later. Adalimumab therapy was of 12-64 months' duration (mean, 36 months). At the time of initiation, 14 patients were using other agents concomitantly with adalimumab; 3 patients were on adalimumab monotherapy. At 1 year's follow-up, 12 patients were using combination therapy, and 3 patients were on adalimumab monotherapy: 11 patients had no evidence of inflammation. Side effects included pain at site of injection in 3 patients, anemia in 1 patient, and depression in 1 patient.
  
  
  CONCLUSIONS
  In our study cohort, adalimumab was effective in inducing steroid-free remission. It was well tolerated, especially in combination with other immunomodulatory agents. The dosing and the interval can be adjusted to further improve inflammation control.
authors.affiliation: Massachusetts Eye Research and Surgery Institution (MERSI), Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation (OIUF), Waltham, Massachusetts.
authors.forename: Claudia
authors.initials: C
authors.lastname: Castiblanco
authors.affiliation: Massachusetts Eye Research and Surgery Institution (MERSI), Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation (OIUF), Waltham, Massachusetts.
authors.forename: Halea
authors.initials: H
authors.lastname: Meese
authors.affiliation: Massachusetts Eye Research and Surgery Institution (MERSI), Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation (OIUF), Waltham, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: sfoster@mersi.com.
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
mesh_terms: D000047:Academies and Institutes / Q000458:organization & administration; D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008404:Massachusetts; D009885:Ophthalmology / Q000458:organization & administration; D012189:Retrospective Studies; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000893:Anti-Inflammatory Agents; D000068879:Adalimumab