Use of anti-TNF Etanercept in paediatric patients with autoimmune disease and ocular involvement: the Parma experience

Objective

Previous studies showed that treatment with anti-TNF Etanercept in patients with autoimmune disease such as juvenile rheumatoid arthritis (JRA) or Behçet's Disease provides clinical improvement and efficacy. We evaluated the effectiveness of anti-TNF therapy on ocular involvement and its toxicity.

Methods

6 Patients with autoimmune disease, followed in our Centre, have been evaluated since January 2007 until May 2008; 4 of them were treated with Etanercept since the beginning of the study, 1 for 5 months and 1 for 3 months. In all patients Etanercept was added to a polipharmacological immunomodulating therapy scheme, including Cyclosporine, Methotrexate and steroids. Safety was assessed by monitoring rates of serious adverse events (SAEs), effects on hepatic and renal function and serious infections rates. Efficacy on ocular involvement was assessed by monitoring and measuring inflammatory relapses.

Results

All patients studied received complete efficacy assessments. During the study period we observed neither SAEs nor serious infectious diseases. All patients enrolled in the study didn't show any effect on hepatic and renal function due to Etanercept's use. Concerning the effectiveness of Etanercept on ocular involvement, we observed only 1 inflamatory relapse in 1 patient, at the beginning of anti-TNF treatment.

Conclusion

In our study Etanercept showes an acceptable safety profile on hepatic and renal function and on the risk of serious infections in children with ocular involvement in autoimmune diseases; moreover, it provides significant improvement in disease's ocular manifestations.