Christoph Tappeiner1, Elisabetta Miserocchi1, Bahram Bodaghi1, Kaisu Kotaniemi1, Friederike Mackensen1, Valeria Gerloni1, Pierre Quartier1, Thomas Lutz1, Arnd Heiligenhaus2. 1. From the Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Department of Ophthalmology, St. Franziskus Hospital, Münster, and University Duisburg-Essen, and Department of Ophthalmology, and Department of General Pediatrics, Centre for Pediatric and Adolescent Medicine, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany; Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, and Department of Rheumatology, Pediatric Rheumatology Unit, Istituto Ortopedico G. Pini University, Milan, Italy; Department of Ophthalmology, Hôpital Pitié-Salpêtrière, and Paris-Descartes University, IMAGINE and Pediatric Immunology-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital, Paris, France; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.C. Tappeiner, MD, Department of Ophthalmology, Inselspital, University of Bern, and Department of Ophthalmology, St. Franziskus Hospital, Münster; E. Miserocchi, MD, Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele; B. Bodaghi, MD, PhD, Department of Ophthalmology, Hôpital Pitié-Salpêtrière; K. Kotaniemi, MD, PhD, Department of Ophthalmology, Helsinki University Hospital; F. Mackensen, MD, Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg; V. Gerloni, MD, Department of Rheumatology, Pediatric Rheumatology Unit, Istituto Ortopedico G. Pini University;P. Quartier, MD, Paris-Descartes University, IMAGINE and Pediatric Immunology-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital; T. Lutz, MD, Department of General Pediatrics, Centre for Pediatric and Adolescent Medicine and Interdisciplinary Uveitis Center, University of Heidelberg; A. Heiligenhaus, MD, Department of Ophthalmology, St. Franziskus Hospital, Münster, and University Duisburg-Essen. 2. From the Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; Department of Ophthalmology, St. Franziskus Hospital, Münster, and University Duisburg-Essen, and Department of Ophthalmology, and Department of General Pediatrics, Centre for Pediatric and Adolescent Medicine, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany; Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, and Department of Rheumatology, Pediatric Rheumatology Unit, Istituto Ortopedico G. Pini University, Milan, Italy; Department of Ophthalmology, Hôpital Pitié-Salpêtrière, and Paris-Descartes University, IMAGINE and Pediatric Immunology-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital, Paris, France; Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.C. Tappeiner, MD, Department of Ophthalmology, Inselspital, University of Bern, and Department of Ophthalmology, St. Franziskus Hospital, Münster; E. Miserocchi, MD, Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele; B. Bodaghi, MD, PhD, Department of Ophthalmology, Hôpital Pitié-Salpêtrière; K. Kotaniemi, MD, PhD, Department of Ophthalmology, Helsinki University Hospital; F. Mackensen, MD, Department of Ophthalmology and Interdisciplinary Uveitis Center, University of Heidelberg; V. Gerloni, MD, Department of Rheumatology, Pediatric Rheumatology Unit, Istituto Ortopedico G. Pini University;P. Quartier, MD, Paris-Descartes University, IMAGINE and Pediatric Immunology-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital; T. Lutz, MD, Department of General Pediatrics, Centre for Pediatric and Adolescent Medicine and Interdisciplinary Uveitis Center, University of Heidelberg; A. Heiligenhaus, MD, Department of Ophthalmology, St. Franziskus Hospital, Münster, and University Duisburg-Essen. arnd.heiligenhaus@uveitis-zentrum.de.
Abstract
OBJECTIVE: Abatacept (ABA), a selective T cell costimulation modulator that binds to CD80 and CD86 on antigen-presenting cells, was investigated for its antiinflammatory effect in treating severe chronic uveitis associated with juvenile idiopathic arthritis (JIA). METHODS: Our retrospective study was conducted by members of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC). Patients with JIA who are receiving ABA treatment for active uveitis were included. In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, immunosuppressives, and at least 1 tumor necrosis factor-α inhibitor. A standardized protocol was used to document uveitis (MIWGUC) and arthritis. Baseline visit and visits at 3, 6, 9, and 12 months before and after ABA start were evaluated. Primary outcome measure was defined as achievement of uveitis inactivity; secondary outcome measures were tapering of corticosteroid and/or immunosuppressive treatment, and occurrence of complications. RESULTS: In all, 21 patients (16 female) with active uveitis (n = 21) and arthritis (n = 18) were included (mean age 11.8 ± 3.6 yrs). In 7 of 18 patients with active arthritis at baseline, inactivity was achieved following ABA treatment. Uveitis inactivity was achieved in 11 patients, but recurred later in 8 of them, and remained active in another 10 cases. Systemic corticosteroids or immunosuppression were tapered in 3 patients, but uveitis recurred in all of them during further followup. Ocular complications secondary to uveitis were present in 17 patients at baseline, while 3 patients developed new ocular complications during followup. CONCLUSION: A sustained response to ABA was uncommon in patients with severe and refractory uveitis.
OBJECTIVE: Abatacept (ABA), a selective T cell costimulation modulator that binds to CD80 and CD86 on antigen-presenting cells, was investigated for its antiinflammatory effect in treating severe chronic uveitis associated with juvenile idiopathic arthritis (JIA). METHODS: Our retrospective study was conducted by members of the Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC). Patients with JIA who are receiving ABA treatment for active uveitis were included. In all patients, uveitis had been refractory to previous topical and systemic corticosteroids, immunosuppressives, and at least 1 tumor necrosis factor-α inhibitor. A standardized protocol was used to document uveitis (MIWGUC) and arthritis. Baseline visit and visits at 3, 6, 9, and 12 months before and after ABA start were evaluated. Primary outcome measure was defined as achievement of uveitis inactivity; secondary outcome measures were tapering of corticosteroid and/or immunosuppressive treatment, and occurrence of complications. RESULTS: In all, 21 patients (16 female) with active uveitis (n = 21) and arthritis (n = 18) were included (mean age 11.8 ± 3.6 yrs). In 7 of 18 patients with active arthritis at baseline, inactivity was achieved following ABA treatment. Uveitis inactivity was achieved in 11 patients, but recurred later in 8 of them, and remained active in another 10 cases. Systemic corticosteroids or immunosuppression were tapered in 3 patients, but uveitis recurred in all of them during further followup. Ocular complications secondary to uveitis were present in 17 patients at baseline, while 3 patients developed new ocular complications during followup. CONCLUSION: A sustained response to ABA was uncommon in patients with severe and refractory uveitis.
Authors: Sheila T Angeles-Han; Sarah Ringold; Timothy Beukelman; Daniel Lovell; Carlos A Cuello; Mara L Becker; Robert A Colbert; Brian M Feldman; Gary N Holland; Polly J Ferguson; Harry Gewanter; Jaime Guzman; Jennifer Horonjeff; Peter A Nigrovic; Michael J Ombrello; Murray H Passo; Matthew L Stoll; C Egla Rabinovich; H Nida Sen; Rayfel Schneider; Olha Halyabar; Kimberly Hays; Amit Aakash Shah; Nancy Sullivan; Ann Marie Szymanski; Marat Turgunbaev; Amy Turner; James Reston Journal: Arthritis Care Res (Hoboken) Date: 2019-04-25 Impact factor: 4.794
Authors: Sheila T Angeles-Han; Sarah Ringold; Timothy Beukelman; Daniel Lovell; Carlos A Cuello; Mara L Becker; Robert A Colbert; Brian M Feldman; Gary N Holland; Polly J Ferguson; Harry Gewanter; Jaime Guzman; Jennifer Horonjeff; Peter A Nigrovic; Michael J Ombrello; Murray H Passo; Matthew L Stoll; C Egla Rabinovich; H Nida Sen; Rayfel Schneider; Olha Halyabar; Kimberly Hays; Amit Aakash Shah; Nancy Sullivan; Ann Marie Szymanski; Marat Turgunbaev; Amy Turner; James Reston Journal: Arthritis Rheumatol Date: 2019-04-25 Impact factor: 10.995