Successful treatment with infliximab after adalimumab failure in pediatric noninfectious uveitis

Noy Ashkenazy, Ujwala S. Saboo, Ashley Abraham, Cristiana Ronconi, Jennifer H Cao

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the use of infliximab after adalimumab failure in the treatment of pediatric noninfectious uveitis. Methods: A retrospective analysis was performed on the medical records of pediatric patients with noninfectious uveitis treated with infliximab for a minimum of 6 months after previously failing to achieve steroid-free remission using adalimumab at the University of Texas Medical School and Children's Medical Center between September 2015 and March 2018. Rates of achieving disease activity quiescence and steroid-free remission as well as incidence of adverse events were calculated. Results: A total of 13 patients with noninfectious uveitis refractory to treatment with adalimumab met inclusion criteria. Three (23%) had anterior uveitis, 4 (31%) had pars planitis, and 6 (46%) had panuveitis. Eleven (85%) patients had preexisting ocular comorbidities. Of these, 4 (31%) had retinal vasculitis, and 1 (7.7%) had cystoid macular edema. There was a 100% response rate to treatment with infliximab following failure to achieve disease quiescence on adalimumab. At mean follow-up time of 21 months (range, 8-31) from initiation of infliximab, there was a reduction in steroid dependence from 100% to 15% after transitioning from adalimumab to infliximab (P < 0.001). Nine patients (69%) had achieved steroid-free remission on infliximab therapy. The mean time to steroid-free remission was 8.7 months. Conclusions: In our study cohort, infliximab was used successfully in all cases of recalcitrant pediatric noninfectious uveitis that previously failed adalimumab therapy.

Original languageEnglish (US)
JournalJournal of AAPOS
DOIs
StatePublished - Jan 1 2019

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Uveitis
Pediatrics
Steroids
Therapeutics
Pars Planitis
Panuveitis
Retinal Vasculitis
Anterior Uveitis
Macular Edema
Infliximab
Adalimumab
Treatment Failure
Medical Schools
Medical Records
Comorbidity
Cohort Studies
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

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Successful treatment with infliximab after adalimumab failure in pediatric noninfectious uveitis. / Ashkenazy, Noy; Saboo, Ujwala S.; Abraham, Ashley; Ronconi, Cristiana; Cao, Jennifer H.

In: Journal of AAPOS, 01.01.2019.

Research output: Contribution to journalArticle

Ashkenazy, Noy ; Saboo, Ujwala S. ; Abraham, Ashley ; Ronconi, Cristiana ; Cao, Jennifer H. / Successful treatment with infliximab after adalimumab failure in pediatric noninfectious uveitis. In: Journal of AAPOS. 2019.
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