抗风湿药物英夫利昔单抗治疗儿童葡萄膜炎的回顾性病例总结

作     者：Rajaraman R. T. Kimura Y. Li S. D.S. Chu, 王文军(译) 

作者机构：不详 Institute of Ophthalmology and-Visual Sciences UMD- NJ-New Jersey Medical School Doctors Office Center 90 Bergen Street Newark NJ 07101 United States 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2006年第2卷第6期

页      面：54-55页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：顽固性葡萄膜炎 单抗治疗 抗风湿药物 病例研究 回顾性 儿童 风湿性关节炎 视网膜脉管炎 睫状体扁平部 平均年龄 

摘      要：Purpose: To assess the response and adverse events associated with infliximab treatment for refractory,noninfectious pediatric uveitis. Design: Retrospective noncomparative case series of pediatric patients with refractory uveitis treated with infliximab. Participants: Six patients were identified. Diagnoses of the participants included idiopathic uveitis (n=1),juvenile rheumatoid arthritis with uveitis (n=3),idiopathic retinal vasculitis with uveitis (n=1),and bilateral pars planitis,with vitreitis and papillitis of the left eye (n=1). Uveitis developed in the patients (5 female,1 male) at a mean age of 9.0 years (± 5.0 years; range,0.9-14.8 years). All patients had bilateral eye involvement. These patients were refractory to or dependent on topical steroids (n=4),oral prednisone (n=3),or both,and were also refractory to the following therapies: methotrexate (n=6),cyclosporine (n=3),mycophenolate mofetil (n=3),etanercept (n=3),and daclizumab (n=1). Intervention: All patients initially received infliximab at doses between 5 and 10 mg/kg at 2-to 4-week intervals,and then were maintained at 4-to 8-week intervals at doses of 5 to 18 mg/kg. Mean follow-up time on treatment has been 48.1 weeks (± 14.9 weeks; range,32-74 weeks). Main Outcome Measures: Primary outcome measures included the quantitative measurement of the amount of ocular inflammation in different locations within the eye. Patients were monitored for infusion reactions as well as other potential side effects. The children’ s clinical status,complete blood counts,and liver function panels were monitored by pediatric rheumatologists every 6 weeks. Results: All 6 patients showed reduction in their intraocular inflammation after infliximab therapy was initiated. Furthermore,control of ocular inflammation was achieved while receiving infliximab therapy. Topical and systemic corticosteroids were able to be discontinued in all patients except for 1 patient,who is currently weaning off prednisone. The only adverse