Abstract
Background
Non-infectious uveitis represents one of the most common causes of blindness, even at pediatric age; in particular, idiopathic chronic uveitis can pose significant difficulties during treatment, due to a partial response to TNF-α antagonists. To date, very few case series exist describing the treatment of idiopathic uveitis not adequately controlled by TNF-α antagonists. The aim of our study is to describe the role of abatacept in achieving remission in patients with idiopathic uveitis previously treated with TNF-α antagonists, and to assess how long abatacept efficacy is maintained during follow-up. The treatment’s safety profile and tolerability were also specifically investigated.
Methods
Three patients affected with chronic idiopathic uveitis, who have been treated with abatacept due to loss of efficacy of TNF-α antagonists, were reviewed. Details of the demographic and clinical characteristics were recorded, and a summary of the medical history was obtained. Patients were regularly reviewed in the ophthalmology and rheumatology clinics. Assessment of their ocular condition was characterized according to the Standardization of Uveitis Nomenclature (SUN) group.
Results
In our patients, abatacept was able to induce remission and to discontinue systemic corticosteroids after a mean of 30 weeks; the drug maintained its efficacy through a long follow-up period (42, 33, and 18 months respectively), with an excellent safety profile.
Conclusion
Our small case series seems to suggest abatacept to be a promising therapy in children affected with chronic idiopathic uveitis not adequately controlled by TNF-α antagonists.
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Acknowledgments
We thanks Dr Roberto Caputo, Head of the Ophthalmology Department in Anna Meyer Children Hospital, for critically reviewing the manuscript.
Conflict of Interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.
Patient Consent Statement
In all cases, institutional permits for off-label use and informed consent were obtained. Therefore, the patients/next of kin/guardians have consented to the submission of the case reports for submission to the journal. This study has been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.
Ethics approval for the study was given by our local committee on research ethics.
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Edoardo Marrani and Valeria Paganelli contributed equally to this work.
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Marrani, E., Paganelli, V., de Libero, C. et al. Long-term efficacy of abatacept in pediatric patients with idiopathic uveitis: a case series. Graefes Arch Clin Exp Ophthalmol 253, 1813–1816 (2015). https://doi.org/10.1007/s00417-015-3140-x
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DOI: https://doi.org/10.1007/s00417-015-3140-x