%0 Journal Article %A Melissa A. Lerman %A Jon M. Burnham %A Peter Y. Chang %A Ebenezer Daniel %A C. Stephen Foster %A Sean Hennessy %A Douglas A. Jabs %A Marshall M. Joffe %A R. Oktay Kaçmaz %A Grace A. Levy-Clarke %A Monte D. Mills %A Robert B. Nussenblatt %A James T. Rosenbaum %A Eric B. Suhler %A Jennifer E. Thorne %A John H. Kempen %T Response of Pediatric Uveitis to Tumor Necrosis Factor-α Inhibitors %D 2013 %R 10.3899/jrheum.121180 %J The Journal of Rheumatology %P jrheum.121180 %X Objective To evaluate the outcome of tumor necrosis factor-α inhibition (anti-TNF) for pediatric uveitis. Methods We retrospectively assessed children (age ≤ 18 yrs) with noninfectious uveitis receiving anti-TNF at 5 uveitis centers and 1 pediatric rheumatology center. Incident treatment success was defined as minimal or no uveitis activity at ≥ 2 consecutive ophthalmological examinations ≥ 28 days apart while taking no oral and ≤ 2 eyedrops/day of corticosteroids. Eligible children had active uveitis and/or were taking higher corticosteroid doses. Results Among 56 eligible children followed over 33.73 person-years, 52% had juvenile idiopathic arthritis (JIA) and 75% had anterior uveitis (AU). The Kaplan-Meier estimated proportion achieving treatment success within 12 months was 75% (95% CI 62%–87%). Complete absence of inflammatory signs with discontinuation of all corticosteroids was observed in an estimated 64% by 12 months (95% CI 51%–76%). Diagnoses of JIA or AU were associated with greater likelihood of success, as was the oligoarticular subtype among JIA cases. In a multivariable model, compared to those with JIA-associated AU, those with neither or with JIA or AU alone had a 75%–80% lower rate of achieving quiescence under anti-TNF, independent of the number of immunomodulators previously or concomitantly prescribed. Uveitis reactivated within 12 months of achieving quiescence in 14% of those continuing anti-TNF (95% CI 6%–31%). The incidence of discontinuation for adverse effects was 8%/year (95% CI 1%–43%). Conclusion Treatment with anti-TNF was successful and sustained in a majority of children with noninfectious uveitis, and treatment-limiting toxicity was infrequent. JIA-associated AU may be especially responsive to anti-TNF. %U https://www.jrheum.org/content/jrheum/early/2013/06/27/jrheum.121180.full.pdf