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Changing biological disease modifying treatment for paediatric uveitis in the real world
Author(s) -
Oh Lawrence J.,
Nguyen Chu L.,
Phan Kevin,
Wong Eugene,
Zagora Sophia,
SinghGrewal Davinder,
Chaitow Jeffrey,
Grigg John R.,
McCluskey Peter
Publication year - 2019
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.13494
Subject(s) - medicine , uveitis , adverse effect , prednisolone , visual acuity , corticosteroid , ophthalmology , surgery
Importance Paediatric uveitis is a severe sight‐threatening uveitis due to disease progression and treatment failure. Biological agents are a promising new treatment. This study provides real‐world data on their use from Sydney, Australia. Background Traditionally corticosteroids and non‐biological immunosuppressive agents were used to treat paediatric uveitis, often with poor outcomes. Design Retrospective, chart review over an 8‐year period at a tertiary referral eye hospital. Participants A total of 27 paediatric uveitis patients treated with biological agents. Methods Chart review of demographic data and treatment outcomes. Main Outcome Measures Treatment efficacy (corticosteroid‐sparing effect, topical steroid cessation/reduction, reduction in systemic‐steroid sparing agents, change in intraocular inflammation, visual acuity and central macular thickness); treatment failure; and adverse events. Data were collected at biological initiation, 6 weeks, 6 months and 12 months. Results Biological therapy over 1 year was effective with prednisolone dose reduced to <5 mg/day in five of six patients (83%), number of systemic steroid‐sparing agents was reduced to ≤1 in two of four patients (50%) and cessation of topical steroid achieved in 12/41 of eyes (29%). Improvement of anterior chamber cells by two grades occurred in 20/25 eyes (80%), improvement of logMAR to ≤0.3 occurred in 12/18 eyes (67%) and macular oedema decreased in 4/5 eyes (80%). Treatment failure occurred in six eyes (13.01%) and five patients (18.5%) developed an adverse reaction. Conclusions and Relevance Biological therapy was effective in paediatric patients with uveitis. Intraocular inflammation improved with maintained visual acuity, systemic corticosteroid dose decreased and there was a low frequency of adverse events.