期刊
JOURNAL OF RHEUMATOLOGY
卷 41, 期 1, 页码 136-139出版社
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.130594
关键词
UVEITIS; JUVENILE ARTHRITIS; IMMUNOSUPPRESSION
类别
资金
- NIHR Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust
- UCL Institute of Ophthalmology, University Hospitals Bristol NHS Foundation Trust
- University of Bristol
Objective. To assess the safety and efficacy of noncorticosteroid triple immunosuppressive therapy in the treatment of refractory chronic noninfectious childhood uveitis. Methods. Subjects were retrospectively selected from a database. Patients were included if they were diagnosed with chronic, noninfectious uveitis at 16 years of age or under and treated with triple immunosuppressive therapy for at least 6 months (following failure of a combination of 2 immunosuppressants). Patient demographics, diagnoses, duration of uveitis, drug dosages, active joint inflammation, and ophthalmologic data were recorded. Efficacy outcomes for triple therapy were recorded at 6 months. Results. Thirteen patients with bilateral uveitis were included. Using Standardized Uveitis Nomenclature (SUN) criteria, at 6 months only 11 eyes (42%) had a 2-step improvement in anterior chamber cell inflammation (n = 26). In addition, 2 patients required additional oral corticosteroid treatment. There were 4 significant infectious adverse events during a total of 21.9 patient-years (PY) on triple therapy (0.18 events per PY). Conclusion. In this group of children with refractory uveitis, addition of a third immunosuppressive agent did not confer substantial benefit in redressing ocular inflammation and was associated with significant infections in a minority of patients.
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