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难治性儿童葡萄膜炎的生物反应调节剂疗法

Biological response modifier therapy for refractory childhood uveitis.

作者信息

Gallagher Michael, Quinones Karina, Cervantes-Castañeda Rene Antonio, Yilmaz Taygan, Foster C Stephen

机构信息

Massachusetts Eye Research and Surgery Institute, 5 Cambridge Center, 8th Floor, Cambridge, MA 02142, USA.

出版信息

Br J Ophthalmol. 2007 Oct;91(10):1341-4. doi: 10.1136/bjo.2007.124081. Epub 2007 Jun 7.

Abstract

PURPOSE

To evaluate the use of biological response modifiers (BRM) in the treatment of refractory childhood uveitis.

DESIGN

Retrospective non-comparative case series of pediatric patients with uveitis treated with BRM.

PARTICIPANTS

23 pediatric patients.

METHODS

All children (18 years or younger) who received a BRM were assessed for visual changes, time to control inflammation, and any associated adverse side effects. Thirteen patients were treated with infliximab, five with adalimumab, and five with daclizumab. All patients had bilateral eye involvement. Diagnoses of the participants included juvenile idiopathic arthritis, keratouveitis, sarcoid panuveitis, Adamantiades-Behcets disease, and idiopathic panuveitis.

MAIN OUTCOME MEASURES

Inflammation and visual acuity.

RESULTS

In the infliximab group 16 of 26 eyes (62%), and 10 of 13 patients (77%) demonstrated an improvement in visual acuity. Twenty of 26 eyes (77%) demonstrated an improvement in the degree of inflammation. In the adalimumab group, four of 10 eyes (40%) demonstrated an improvement in visual acuity, with five of 10 eyes (50%) demonstrating an improvement in inflammation. Four of 10 eyes (40%) in the daclizumab group demonstrated an improvement in vision with eight of 10 eyes (80%) demonstrating an improvement in inflammation.

CONCLUSION

BRM appear to be safe to use in children, and represent a useful therapeutic adjunctive drug group for treating recalcitrant childhood uveitis.

摘要

目的

评估生物反应调节剂(BRM)在治疗儿童难治性葡萄膜炎中的应用。

设计

对接受BRM治疗的葡萄膜炎儿科患者进行回顾性非对照病例系列研究。

参与者

23名儿科患者。

方法

对所有接受BRM治疗的18岁及以下儿童评估视力变化、炎症控制时间以及任何相关的不良副作用。13名患者接受英夫利昔单抗治疗,5名接受阿达木单抗治疗,5名接受达利珠单抗治疗。所有患者均为双眼受累。参与者的诊断包括幼年特发性关节炎、角膜葡萄膜炎、结节病全葡萄膜炎、贝赫切特病和特发性全葡萄膜炎。

主要观察指标

炎症和视力。

结果

在英夫利昔单抗组中,26只眼中的16只(62%)以及13名患者中的10名(77%)视力有所改善。26只眼中的20只(77%)炎症程度有所改善。在阿达木单抗组中,10只眼中有4只(40%)视力有所改善,10只眼中有5只(50%)炎症有所改善。在达利珠单抗组中,10只眼中有4只(40%)视力改善,10只眼中有8只(80%)炎症改善。

结论

BRM在儿童中使用似乎是安全的,是治疗儿童顽固性葡萄膜炎的一种有用的辅助治疗药物组。

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