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Use of tumor necrosis factor inhibitors in uveitis

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Pediatric and heritable disorders:

Use of tumor necrosis factor inhibitors in uveitis

www.co-rheumatology.com/pt/re/corheum/abstract.00002281-200709000-00015.htm

Current Opinion in Rheumatology. 19(5):482-486, September 2007.

Rabinovich, C Egla

Abstract:

Purpose of review: Use of tumor necrosis factor-[alpha] blocking agents to

treat chronic pediatric uveitis is becoming recognized as an important

therapeutic modality. This review summarizes the rationale for this use,

highlighting new studies of these agents in pediatric uveitis.

Recent findings: The majority of patients with pediatric uveitis either have

idiopathic uveitis or uveitis associated with juvenile idiopathic arthritis.

Ophthalmologic morbidity among these children is common. Most studies

evaluating tumor necrosis factor-[alpha] blockade in pediatric uveitis are

retrospective case series, with attendant limitations that are inherent to

any retrospective study.

Study of uveitis has been hampered by lack of standardization of disease and

outcome measures, which has been addressed by uveitis experts with

publication of consensus measures.

Data to date suggest that tumor necrosis factor-[alpha] blockade is

efficacious in refractory uveitis. Agents with direct tumor necrosis

factor-[alpha] membrane receptor binding activity may be the most

efficacious. There remain many unanswered questions in the treatment of

pediatric uveitis, including optimal dosing regimen and long-term efficacy.

Summary: Tumor necrosis factor-[alpha] blocking agents play an important

role in the treatment of chronic pediatric uveitis. Prospective comparative

studies are needed so that we may better understand this role.

© 2007 Lippincott & Wilkins, Inc.

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