Anti-TNF-alpha Therapy: Treatment of Severe Uveitis in Childhood
Biester S., Schlote T., Deuter C. M. E., Stübiger N., Siepmann K., Zierhut M.
University Eye Hospital, Dept. I, Tuebingen
Purpose: Chronic uveitis in childhood can take a severe, vision threatening course. Not in all cases, a systemic immunosuppressive therapy can control the inflammatory activity which is associated with a range of severe possible side effects. We report of our first experiences with an Anti TNF alpha therapy.
Method: Six juvenile patients (14 - 17 years old) with chronic anterior uveitis resistant to convenient immunosuppressive therapy were treated with an anti-TNF alpha-therapy. At the beginning of this therapy, all patients had been already under systemic immunosuppression over a longer time period, but still had intermittent periods of acute inflammation. Five patients were treated with Etanercept, in two of them unsuccessful Etanercept therapy was followed by Infliximab treatment, one patient was treated with Infliximab only.
Results: From five patients treated with Etanercept, two patients remained largely stable during a period of 7 and 22 months. In another two patients inflammatory activity could not be reduced with Etanercept, and therapy was changed to Infliximab. For one of them frequency of recurrences was reduced by shortening of intervals between infusions. For one patient with Etanercept, therapy was stopped because of ongoing inflammatory activity under therapy. The one patient treated with Infliximab only, developed an anaphylactoid reaction during infusion and ha
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