PT  - JOURNAL ARTICLE
AU  - Jessica A. Little
AU  - Ethan S. Sen
AU  - Helen Strike
AU  - Annie Hinchcliffe
AU  - Catherine M. Guly
AU  - Richard W.J. Lee
AU  - Andrew D. Dick
AU  - Athimalaipet V. Ramanan
TI  - The Safety and Efficacy of Noncorticosteroid Triple Immunosuppressive Therapy in the Treatment of Refractory Chronic Noninfectious Uveitis in Childhood
AID  - 10.3899/jrheum.130594
DP  - 2014 Jan 01
TA  - The Journal of Rheumatology
PG  - 136--139
VI  - 41
IP  - 1
4099  - http://www.jrheum.org/content/41/1/136.short
4100  - http://www.jrheum.org/content/41/1/136.full
SO  - J Rheumatol2014 Jan 01; 41
AB  - 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.