@article {Little136, author = {Jessica A. Little and Ethan S. Sen and Helen Strike and Annie Hinchcliffe and Catherine M. Guly and Richard W.J. Lee and Andrew D. Dick and Athimalaipet V. Ramanan}, title = {The Safety and Efficacy of Noncorticosteroid Triple Immunosuppressive Therapy in the Treatment of Refractory Chronic Noninfectious Uveitis in Childhood}, volume = {41}, number = {1}, pages = {136--139}, year = {2014}, doi = {10.3899/jrheum.130594}, publisher = {The Journal of Rheumatology}, abstract = {Objective. To assess the safety and efficacy of noncorticosteroid triple immunosuppressive therapy in the treatment of refractory chronic noninfectious childhood uveitis. Methods. Subjects were retrospectively selected from a database. Patients were included if they were diagnosed with chronic, noninfectious uveitis at 16 years of age or under and treated with triple immunosuppressive therapy for at least 6 months (following failure of a combination of 2 immunosuppressants). Patient demographics, diagnoses, duration of uveitis, drug dosages, active joint inflammation, and ophthalmologic data were recorded. Efficacy outcomes for triple therapy were recorded at 6 months. Results. Thirteen patients with bilateral uveitis were included. Using Standardized Uveitis Nomenclature (SUN) criteria, at 6 months only 11 eyes (42\%) had a 2-step improvement in anterior chamber cell inflammation (n = 26). In addition, 2 patients required additional oral corticosteroid treatment. There were 4 significant infectious adverse events during a total of 21.9 patient-years (PY) on triple therapy (0.18 events per PY). Conclusion. In this group of children with refractory uveitis, addition of a third immunosuppressive agent did not confer substantial benefit in redressing ocular inflammation and was associated with significant infections in a minority of patients.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/41/1/136}, eprint = {https://www.jrheum.org/content/41/1/136.full.pdf}, journal = {The Journal of Rheumatology} }