Biological Therapy in Noninfectious Pediatric Uveitis: A Systematic Review

Area of Science:

• Ophthalmology
• Immunology
• Pediatrics

Background:

• Noninfectious pediatric uveitis is a serious condition that can lead to blindness.
• It is often linked to systemic diseases and may not respond well to standard treatments like steroids and immunosuppressants.
• Biological response modifiers offer potential therapeutic options, but their long-term safety in children is not well-established.

Purpose of the Study:

• To evaluate the efficacy and safety of biological therapy for noninfectious pediatric uveitis.
• To synthesize existing evidence on biological treatments for this condition in children.

Main Methods:

• A systematic review of original studies was conducted.
• Included studies focused on biological therapy for children with noninfectious uveitis.
• Evidence quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Main Results:

• Nine studies involving 526 children were analyzed.
• Adalimumab demonstrated superiority over placebo in reducing inflammatory activity and steroid use (low-certainty evidence).
• No significant differences were found in adverse events between adalimumab and placebo, nor in treatment response or adverse effects between adalimumab and infliximab (low to very low-certainty evidence).

Conclusions:

• Current evidence suggests biological therapy is effective and safe for managing noninfectious pediatric uveitis, though the evidence quality is low to very low.
• Larger randomized controlled trials are needed to confirm these findings and provide more robust data on long-term outcomes.