title: Adalimumab for the treatment of refractory noninfectious paediatric uveitis.
abstract: To report the experience of our center with the use of adalimumab (ADA) for the treatment of severe refractory noninfectious paediatric uveitis. The study is a retrospective case series of all paediatric patients with refractory uveitis who were treated with ADA at the Paediatric Uveitis Unit of our center from 2008 to 2015. We present 12 patients (6 Juvenile idiopathic arthritis-associated uveitis, 4 idiopathic panuveitis, 1 early-onset sarcoidosis-associated panuveitis, and 1 intermediate uveitis), with uveitis in 19/24 eyes. Once ADA therapy was started, all the patients presented improved activity according to Standardization of Uveitis Nomenclature (SUN) criteria. Nine out of the 12 patients had structural damage before ADA could be started: cataract (n = 4), glaucoma (n = 2), cystic macular edema (n = 1), exudative retinal detachment (n = 1), and optic disk edema (n = 5). Visual acuity improved or maintained stable in 17/19 affected eyes, and only 2 eyes decreased its visual acuity because of structural damage, which was already present before ADA therapy. In our experience, ADA presents a good safety profile and is efficacious in the treatment of paediatric patients with different forms of refractory noninfectious uveitis.
authors.affiliation: Section of Paediatric Ophthalmology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain. amunozg@salud.madrid.org.
authors.forename: Alicia
authors.initials: A
authors.lastname: Muñoz-Gallego
authors.affiliation: Section of Paediatric Rheumatology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
authors.forename: Estefanía
authors.initials: E
authors.lastname: Barral
authors.affiliation: Section of Paediatric Rheumatology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Enríquez
authors.affiliation: Section of Paediatric Ophthalmology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Tejada
authors.affiliation: Section of Paediatric Ophthalmology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Barceló
authors.affiliation: Section of Paediatric Rheumatology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: de Inocencio
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage*; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001171:Arthritis, Juvenile / Q000150:complications*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity
chemical_list: D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D000068879:Adalimumab
keywords: Adalimumab; Antitumour necrosis factor α; Juvenile idiopathic arthritis; Noninfectious uveitis; Paediatric uveitis; Uveitis