Infliximab in chronic non-infectious paediatric uveitis refractory to previous biologic therapy

Area of Science:

• Ophthalmology
• Immunology
• Pediatrics

Background:

• Non-infectious paediatric uveitis is a vision-threatening condition.
• Biologic therapies are increasingly used, but treatment failure occurs.
• Understanding treatment outcomes after failure is crucial for patient management.

Purpose of the Study:

• To evaluate infliximab efficacy and safety in paediatric non-infectious uveitis patients.
• To compare outcomes of in-class (vs. adalimumab) and across-class biologic switching.

Main Methods:

• Retrospective cohort study at Bristol Eye Hospital.
• Two groups: Group 1 (n=20) switched from adalimumab; Group 2 (n=5) switched from other biologics.
• Primary outcome: change in anterior chamber (AC) activity at 6 and 24 months.

Main Results:

• Group 1 showed significant reduction in AC activity at 6 and 24 months.
• No significant changes in steroid use or visual acuity in Group 1.
• Group 2 outcomes (AC activity, steroid use, visual acuity) did not reach statistical significance.
• Treatment failure in 20% of Group 1; adverse events in 6 patients.

Conclusions:

• Infliximab is effective and safe for paediatric non-infectious uveitis refractory to adalimumab.
• In-class switching to infliximab shows promise.
• Further research may explore across-class switching efficacy.