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Study: Biological response modifiers show efficacy in treating pediatric uveitis
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Biological response modifiers may offer an effective adjunctive treatment option for pediatric patients with refractory uveitis, according to a study by researchers in Massachusetts. With treatment, most patients successfully discontinued receiving systemic prednisone, the authors noted.
C. Stephen Foster, MD, FACS, FACR, and colleagues at Massachusetts Eye Research and Surgery Institute in Cambridge reviewed outcomes for 23 children treated for bilateral uveitis with one of three biological response modifiers. Children averaged 11.2 years of age and were treated for a mean duration of 16.9 months, according to the study.
Specifically, 13 children received Remicade (infliximab, Centocor) over a mean duration of 16.8 months. Five children received Humira (adalimumab, Abbott) over an average of 9.3 months, and five children received Zenapax (daclizumab, Roche) over an average of 24.9 months.
Diagnoses included juvenile idiopathic arthritis, keratouveitis, sarcoid panuveitis, Adamantiades-Behçet's disease and idiopathic panuveitis.
In the infliximab group, uveitis was controlled after an average of 10 weeks, with 16 of 26 eyes (62%) showing an improvement in visual acuity and eight eyes remaining stable. In addition, 20 eyes (77%) showed an improvement in the degree of inflammation and four eyes remained stable, according to the study.
In the adalimumab group, inflammation was controlled after an average of 3.9 weeks of treatment. Four of 10 eyes (40%) showed an improvement in visual acuity, two eyes remained stable and four eyes had a deterioration in vision. Five eyes (50%) had an improvement in inflammation and three eyes (30%) remained stable, the authors reported.
In the daclizumab group, inflammation was controlled after an average of 18 weeks. Four of 10 eyes (40%) had an improvement in visual acuity and five eyes (50%) remained stable. Regarding inflammation, four eyes (80%) showed an improvement and five eyes (50%) remained stable, according to the study.
Biological response modifiers "represent a useful therapeutic adjunctive drug group for treating recalcitrant childhood uveitides," the authors said.
The study is published in the October issue of British Journal of Ophthalmology.