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.

Efficacy and safety of Adalimumab in pediatric non-infectious non-anterior uveitis: real-life experience from the international AIDA network uveitis registry / Vitale, Antonio; Della Casa, Francesca; Guerriero, Silvana; Ragab, Gaafar; Mauro, Angela; Caggiano, Valeria; Cattalini, Marco; DEL GIUDICE, Emanuela; Favale, Rossella; Gaggiano, Carla; Bellicini, Irene; Paroli, Maria Pia; Tharwat Hegazy, Mohamed; Sota, Jurgen; Tufan, Abdurrahman; Balistreri, Alberto; Almaghlouth, Ibrahim; La Torre, Francesco; Więsik-Szewczyk, Ewa; Tarsia, Maria; Hinojosa-Azaola, Andrea; Martín-Nares, Eduardo; Frediani, Bruno; Marco Tosi, Gian; Fonollosa, Alex; Hernández-Rodríguez, José; Hussein Amin, Rana; Lopalco, Giuseppe; Rigante, Donato; Cantarini, Luca; Fabiani, Claudia. - In: OPHTHALMOLOGY AND THERAPY. - ISSN 2193-6528. - (2023). [10.1007/s40123-023-00712-1]

Efficacy and safety of Adalimumab in pediatric non-infectious non-anterior uveitis: real-life experience from the international AIDA network uveitis registry

Emanuela Del Giudice;Maria Pia Paroli;
2023

Abstract

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.
2023
anti-TNF; autoinflammatory diseases; clinical management; ocular involvement; personalized medicine; rare diseases
01 Pubblicazione su rivista::01a Articolo in rivista
Efficacy and safety of Adalimumab in pediatric non-infectious non-anterior uveitis: real-life experience from the international AIDA network uveitis registry / Vitale, Antonio; Della Casa, Francesca; Guerriero, Silvana; Ragab, Gaafar; Mauro, Angela; Caggiano, Valeria; Cattalini, Marco; DEL GIUDICE, Emanuela; Favale, Rossella; Gaggiano, Carla; Bellicini, Irene; Paroli, Maria Pia; Tharwat Hegazy, Mohamed; Sota, Jurgen; Tufan, Abdurrahman; Balistreri, Alberto; Almaghlouth, Ibrahim; La Torre, Francesco; Więsik-Szewczyk, Ewa; Tarsia, Maria; Hinojosa-Azaola, Andrea; Martín-Nares, Eduardo; Frediani, Bruno; Marco Tosi, Gian; Fonollosa, Alex; Hernández-Rodríguez, José; Hussein Amin, Rana; Lopalco, Giuseppe; Rigante, Donato; Cantarini, Luca; Fabiani, Claudia. - In: OPHTHALMOLOGY AND THERAPY. - ISSN 2193-6528. - (2023). [10.1007/s40123-023-00712-1]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1680331
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