Tumornekrosefaktor a-haemning som led i behandling af uveitis hos börn
Sammanfattning
Introduction : To present our experience with anti-TNFa treatment of juvenile idiopatic arthritis (JIA) associated uveitis. Materials and methods: All 11 children with severe uveitis were monitored between 2001 and 2005. Nine of the children had JIA and a set of twins had a rare hereditary granulomatous disease, Blau's syndrome. The patients were selected and the reason for starting anti-TNFa treatment was an insufficient response in the arthritis or uveitis to previous therapy. Results: In all patients the anti-TNFa treatment reduced the activity of uveitis. The response to treatment was related to 1) visual acuity and 2) the reduction of systemic immune-suppressing agents. All 11 children are still on anti-TNFa treatment. Conclusion: Anti-TNFa was effective in treating uveitis in all 11 patients. In patients with active uveitis associated JIA not responding to corticosteroids and methotrexate and with declined vision the trend is to start anti-TNFa treatment early in the inflammatory disease to prevent long term complications to the eyes. The results indicate a superiority of infliximab over Eternacept in the treatment of uveitis.