TNF-alfa blockers- promising therapy for chronic uveitis in very young children

The term uveitis is used clinically to describe a heterogeneous group of diseases, characterized by inflammation of intraocular structures.

Although frequently associated with systemic inflammatory or autoimmune diseases such as Behcet' disease, JIA, JAS, Sarcoidosis, a significant number are labeled "idiopathic".

TNF-alpha blockers which are an effective treatment for systemic diseases associated with uveitis, were found effective in uveitis in animal studies and later in clinical trials.

Three types of TNF-alpha blockers are currently being used: Etanercept, Infliximab and Adalimumab. For Adalimumab no sufficient data exist regarding the use in pediatric age however recent studies show clear preference for Infiliximab over Etanercept for childhood uveitis.

We present four children (age 4, 4.5, 6, 12) diagnosed with chronic childhood uveitis at a very young age which were successfully treated with Infliximab in the pediatric rheumatology clinic at our institution. All of them were initially treated conventionally, and switched to Anti-TNF α because of ineffectiveness of conventional treatment or severe side effects.

Regardless of the small cohort we found Infliximab efficient and safe to use in chronic childhood uveitis at a young age.