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Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry
INTRODUCTION: Scientific evidence of the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious non-anterior uveitis is still limited. The aim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with n...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Healthcare
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10287589/ https://www.ncbi.nlm.nih.gov/pubmed/37166627 http://dx.doi.org/10.1007/s40123-023-00712-1 |
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author | Vitale, Antonio Casa, Francesca Della Guerriero, Silvana Ragab, Gaafar Mauro, Angela Caggiano, Valeria Cattalini, Marco Del Giudice, Emanuela Favale, Rossella Gaggiano, Carla Bellicini, Irene Paroli, Maria Pia Hegazy, Mohamed Tharwat Sota, Jurgen Tufan, Abdurrahman Balistreri, Alberto Almaghlouth, Ibrahim La Torre, Francesco Więsik-Szewczyk, Ewa Tarsia, Maria Hinojosa-Azaola, Andrea Martín-Nares, Eduardo Frediani, Bruno Tosi, Gian Marco Fonollosa, Alex Hernández-Rodríguez, José Amin, Rana Hussein Lopalco, Giuseppe Rigante, Donato Cantarini, Luca Fabiani, Claudia |
author_facet | Vitale, Antonio Casa, Francesca Della Guerriero, Silvana Ragab, Gaafar Mauro, Angela Caggiano, Valeria Cattalini, Marco Del Giudice, Emanuela Favale, Rossella Gaggiano, Carla Bellicini, Irene Paroli, Maria Pia Hegazy, Mohamed Tharwat Sota, Jurgen Tufan, Abdurrahman Balistreri, Alberto Almaghlouth, Ibrahim La Torre, Francesco Więsik-Szewczyk, Ewa Tarsia, Maria Hinojosa-Azaola, Andrea Martín-Nares, Eduardo Frediani, Bruno Tosi, Gian Marco Fonollosa, Alex Hernández-Rodríguez, José Amin, Rana Hussein Lopalco, Giuseppe Rigante, Donato Cantarini, Luca Fabiani, Claudia |
author_sort | Vitale, Antonio |
collection | PubMed |
description | INTRODUCTION: Scientific evidence of the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious non-anterior uveitis is still limited. The aim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis. METHODS: This is an international multicenter study analyzing real-life data referred to pediatric patients treated with ADA for intermediate uveitis/pars planitis, posterior uveitis and panuveitis. Data were drawn from the AutoInflammatory Disease Alliance (AIDA) registry for patients with uveitis. RESULTS: Twenty-one patients (36 affected eyes) were enrolled, and all patients benefited from ADA administration. In detail, 11 patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a significant clinical improvement consisting of a decrease in severity and/or frequency of ocular relapses. The number of ocular flares dropped from 3.91 to 1.1 events/patient/year after ADA introduction (p = 0.0009); macular edema and retinal vasculitis were respectively observed in 18 eyes and 20 eyes at the start of ADA and in 4 eyes and 2 eyes at the last assessment. The mean daily glucocorticoid dosage significantly decreased from 26.8 ± 16.8 mg/day at the start of ADA to 6.25 ± 6.35 mg/day at the last assessment (p = 0.002). Intermediate uveitis/pars planitis (p = 0.01) and posterior uveitis (p = 0.03) were more frequently observed in patients with full response to ADA; panuveitis (p = 0.001) was significantly more frequent among patients continuing to experience uveitic flares. This could be related to a higher use of systemic glucocorticoids (p = 0.002) and conventional immunosuppressants (p = 0.007) at the start of ADA when treating intermediate uveitis/pars planitis. Regarding the safety profile, only one adverse event was reported during ADA treatment, consisting of the development of generalized adenopathy. CONCLUSIONS: ADA proved to have an effective therapeutic role in all pediatric patients with non-anterior uveitis enrolled in the study. An overall glucocorticoid-sparing effect was observed despite the severity of cases enrolled. A more aggressive treatment of panuveitis and posterior uveitis at start of ADA could increase the likelihood of full response to therapy. |
format | Online Article Text |
id | pubmed-10287589 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-102875892023-06-24 Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry Vitale, Antonio Casa, Francesca Della Guerriero, Silvana Ragab, Gaafar Mauro, Angela Caggiano, Valeria Cattalini, Marco Del Giudice, Emanuela Favale, Rossella Gaggiano, Carla Bellicini, Irene Paroli, Maria Pia Hegazy, Mohamed Tharwat Sota, Jurgen Tufan, Abdurrahman Balistreri, Alberto Almaghlouth, Ibrahim La Torre, Francesco Więsik-Szewczyk, Ewa Tarsia, Maria Hinojosa-Azaola, Andrea Martín-Nares, Eduardo Frediani, Bruno Tosi, Gian Marco Fonollosa, Alex Hernández-Rodríguez, José Amin, Rana Hussein Lopalco, Giuseppe Rigante, Donato Cantarini, Luca Fabiani, Claudia Ophthalmol Ther Original Research INTRODUCTION: Scientific evidence of the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious non-anterior uveitis is still limited. The aim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis. METHODS: This is an international multicenter study analyzing real-life data referred to pediatric patients treated with ADA for intermediate uveitis/pars planitis, posterior uveitis and panuveitis. Data were drawn from the AutoInflammatory Disease Alliance (AIDA) registry for patients with uveitis. RESULTS: Twenty-one patients (36 affected eyes) were enrolled, and all patients benefited from ADA administration. In detail, 11 patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a significant clinical improvement consisting of a decrease in severity and/or frequency of ocular relapses. The number of ocular flares dropped from 3.91 to 1.1 events/patient/year after ADA introduction (p = 0.0009); macular edema and retinal vasculitis were respectively observed in 18 eyes and 20 eyes at the start of ADA and in 4 eyes and 2 eyes at the last assessment. The mean daily glucocorticoid dosage significantly decreased from 26.8 ± 16.8 mg/day at the start of ADA to 6.25 ± 6.35 mg/day at the last assessment (p = 0.002). Intermediate uveitis/pars planitis (p = 0.01) and posterior uveitis (p = 0.03) were more frequently observed in patients with full response to ADA; panuveitis (p = 0.001) was significantly more frequent among patients continuing to experience uveitic flares. This could be related to a higher use of systemic glucocorticoids (p = 0.002) and conventional immunosuppressants (p = 0.007) at the start of ADA when treating intermediate uveitis/pars planitis. Regarding the safety profile, only one adverse event was reported during ADA treatment, consisting of the development of generalized adenopathy. CONCLUSIONS: ADA proved to have an effective therapeutic role in all pediatric patients with non-anterior uveitis enrolled in the study. An overall glucocorticoid-sparing effect was observed despite the severity of cases enrolled. A more aggressive treatment of panuveitis and posterior uveitis at start of ADA could increase the likelihood of full response to therapy. Springer Healthcare 2023-05-11 2023-08 /pmc/articles/PMC10287589/ /pubmed/37166627 http://dx.doi.org/10.1007/s40123-023-00712-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Vitale, Antonio Casa, Francesca Della Guerriero, Silvana Ragab, Gaafar Mauro, Angela Caggiano, Valeria Cattalini, Marco Del Giudice, Emanuela Favale, Rossella Gaggiano, Carla Bellicini, Irene Paroli, Maria Pia Hegazy, Mohamed Tharwat Sota, Jurgen Tufan, Abdurrahman Balistreri, Alberto Almaghlouth, Ibrahim La Torre, Francesco Więsik-Szewczyk, Ewa Tarsia, Maria Hinojosa-Azaola, Andrea Martín-Nares, Eduardo Frediani, Bruno Tosi, Gian Marco Fonollosa, Alex Hernández-Rodríguez, José Amin, Rana Hussein Lopalco, Giuseppe Rigante, Donato Cantarini, Luca Fabiani, Claudia Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title | Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title_full | Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title_fullStr | Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title_full_unstemmed | Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title_short | Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry |
title_sort | efficacy and safety of adalimumab in pediatric non-infectious non-anterior uveitis: real-life experience from the international aida network uveitis registry |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10287589/ https://www.ncbi.nlm.nih.gov/pubmed/37166627 http://dx.doi.org/10.1007/s40123-023-00712-1 |
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