TY - JOUR T1 - The Safety and Efficacy of Noncorticosteroid Triple Immunosuppressive Therapy in the Treatment of Refractory Chronic Noninfectious Uveitis in Childhood JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.130594 SP - jrheum.130594 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 Y1 - 2013/10/01 UR - http://www.jrheum.org/content/early/2013/09/27/jrheum.130594.abstract N2 - 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. ER -