Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease, and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Clinical Pediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy.
Ocul Immunol Inflamm. 2024 Aug;32(6):877-883. doi: 10.1080/09273948.2022.2106577. Epub 2022 Aug 5.
Registry-based observational prospective study aimed at describing the use of biologic drugs in pediatric-onset scleritis. Data were collected at baseline, at 3-, 6-, 12-month follow-up and at last assessment. Scleral inflammation was graded according to Sen classification. Five patients (9 eyes) treated with adalimumab, infliximab, abatacept and secukinumab were included. All patients were previously treated with conventional immunosuppressors and glucocorticoids. Median biologic treatment duration was 28 (IQR = 118) months. At 6-months, scleritis resolved in all eyes. At 12-months, complete disease control was observed in 7/9 eyes (77.8%). The number of relapses 12 months before and after treatment initiation was 17 and 2, respectively. Mean BCVA was 0.83 (range 0.3-1.0) at baseline and 1.0 for all eyes after 12 months. Glucocorticoids had been withdrawn in 4/5 patients.In conclusion, biological agents proved to be effective in pediatric-onset scleritis, allowing a noticeable steroid-sparing effect and preserving visual function and bulbar integrity.
基于注册的观察性前瞻性研究旨在描述生物药物在儿童发病巩膜炎中的应用。数据在基线、3、6、12 个月随访和最后评估时收集。巩膜炎症根据 Sen 分类进行分级。纳入了 5 名（9 只眼）接受阿达木单抗、英夫利昔单抗、阿巴西普和司库奇尤单抗治疗的患者。所有患者均曾接受过传统免疫抑制剂和糖皮质激素治疗。生物治疗的中位持续时间为 28（IQR=118）个月。6 个月时，所有眼睛的巩膜炎均消退。12 个月时，7/9 只眼（77.8%）完全控制疾病。治疗前 12 个月和治疗后 12 个月的复发次数分别为 17 次和 2 次。平均 BCVA 为 0.83（范围 0.3-1.0），所有眼睛在 12 个月后均为 1.0。4/5 名患者已停用糖皮质激素。总之，生物制剂在儿童发病巩膜炎中证明是有效的，可显著减少类固醇的使用，并保持视力和眼球完整性。
