Uveítis pediática no infecciosa, una experiencia de una cohorte colombiana

Abstract

Background: Non-infectious pediatric uveitis has the potential to produce severe visual complications and its traditional pharmacologic treatment is associated with severe adverse effects.1 Infliximab and Adalimumab are two Biologic Response Modifiers available for the treatment of refractory pediatric uveitis. They specifically attach to TNFα and prevent its interaction with its receptor, which is directly involved in the inflammation process and subsequent tissue damage. 2,3 •Methods: Retrospective cohort study was performed by means of a retrospective review of medical records of 35 patients diagnosed with uveitis during years 2009-2015. Comparisons between ocular inflammation control, time of response, and adverse effect in patients treated with IFN or ADA plus low doses of Methotrexate vs. Methotrexate (MTX) as unique therapy were performed. •Results: 45.7% of the population was female whose mean age for symptom onset and diagnosis was 9 years of age. 80% were idiopathic uveitis, followed by Vogt-Koyanagi-Harada (8,5%) y JIA (5,7%). 91,4% had bilateral ocular compromise and 2 cases of amblyopia were documented. 12,9% of the patients who received MTX as a first line treatment required step up treatment as a consequence of liver enzyme elevation and gastrointestinal discomfort. Mean time to achieve inflammation control with MTX was 9 weeks, and 8,75 weeks for Adalimumab, (P: 0,90). We compared MTX’s and Anti-TNF capacity to control ocular inflammation which showed no significant difference, (P: 0.88).