Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Prospective Study of Infliximab for Treatment of Pediatric Uveitis.

Rabinovich4,  Egla C., Wootton4,  Janet, Zemel3,  Lawrence S., Imundo2,  Lisa F., Weiss5,  Jennifer E., Abramson7,  Leslie S., Hoeltzel1,  Mark F.

Children's Mercy Hospital, Kansas City, MO
Childrens Hospital of NY, New York, NY
Connecticut Childrens Med Ctr, Hartford, CT
Duke University Medical Center, Durham, NC
Hackensack Univ Med Ctr, Hackensack, NJ
The Hospital for Sick Children, Toronto, ON, Canada
University of Vermont, Morrisville, VT

Background:

Uveitis is a persistent disease for which there is little prospective data on treatment. Previous retrospective studies suggest TNF blockade may be efficacious for treatment of uveitis, but do not address time to response or optimal dose.

Methods:

Ongoing 9 month multi-center prospective study of infliximab for treatment of persistent pediatric inflammatory uveitis (onset <= 16 yrs), randomizing subjects to one of 2 initial doses: 5 mg/kg or 10mg/kg monthly. Scheduled ophthalmologic exams utilized the Standardization of Nomenclature (SUN) criteria. Entry criteria: >= 1+ anterior chamber inflammation, failure of at least one DMARD, on stable dose of methotrexate. Primary outcome variable was percent who had improvement per SUN criteria.

Results:

14 subjects (9 female, mean age 11.8 yrs, range 6–19) with persistent inflammatory uveitis (1 sarcoid, 13 idiopathic) from 6 Childhood Arthritis and Rheumatology Research Alliance (CARRA) A sites were randomized to receive 5 mg/kg (N=8) or 10 mg/kg (N=6) initial infliximab dose. At the baseline visit, 5 had unilateral and 7 bilateral inflammation.

Conclusion:

Infliximab works rapidly to decrease inflammation with 57% having 0 to.5+ inflammation after one infusion. Low grade inflammation may persist despite treatment. Improvement persisted 8 months after initiation of infliximab.

Inflammation*Baseline (n)After 1st doseAfter 4th doseAfter 8th dose
 N = 14N = 12N = 12N = 7
3+ (26–50)0000
2+ (16–25)4100
1+ (6–15)10301
0.5+ (1–5)0453
0 (0)0473
* Inflammation is reported utilizing SUN criteria and on the most active eye. Anterior chamber inflammation is graded as cells per high power field (hpf).

To cite this abstract, please use the following information:
Rabinovich, Egla C., Wootton, Janet, Zemel, Lawrence S., Imundo, Lisa F., Weiss, Jennifer E., Abramson, Leslie S., et al; Prospective Study of Infliximab for Treatment of Pediatric Uveitis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :234
DOI: 10.1002/art.28003

Abstract Supplement

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