Edoardo Marrani1, Valeria Paganelli2, Cinzia de Libero3, Rolando Cimaz2, Gabriele Simonini2. 1. Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy. edoardo.marrani@gmail.com. 2. Pediatric Rheumatology, Anna Meyer Children Hospital, Florence, Italy. 3. Pediatric Ophthalmology, Anna Meyer Children Hospital, Florence, Italy.
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. CONCLUSION: 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.
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. CONCLUSION: 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.
Entities:
Keywords:
Abatacept; Biologic therapy for uveitis; Idiopathic uveitis in children; Pediatric uveitis; Uveitis treatment
Authors: Francesco Zulian; Marta Balzarin; Fernanda Falcini; Giorgia Martini; Maria Alessio; Rolando Cimaz; Luca Cimino; Maria Elisabetta Zannin Journal: Arthritis Care Res (Hoboken) Date: 2010-06 Impact factor: 4.794
Authors: Melissa A Lerman; Jon M Burnham; Peter Y Chang; Ebenezer Daniel; C Stephen Foster; Sean Hennessy; Douglas A Jabs; Marshall M Joffe; R Oktay Kaçmaz; Grace A Levy-Clarke; Monte D Mills; Robert B Nussenblatt; James T Rosenbaum; Eric B Suhler; Jennifer E Thorne; John H Kempen Journal: J Rheumatol Date: 2013-07-01 Impact factor: 4.666