Tofacitinib for Refractory Uveitis and Scleritis in Children: A Case Series
Parthopratim Dutta Majumder, Sharanya Abraham, Sridharan Sudharshan, Mahesh Janarthanan, Athimalaipet V Ramanan
Abstract
Purpose This study analyzes the efficacy and safety of tofacitinib in pediatric patients presenting with treatment-resistant uveitis and scleritis.Method Retrospective Chart ReviewResult Nine children diagnosed with uveitis and one with scleritis received oral tofacitinib treatment. The median age of these patients was 9 years, with bilateral involvement observed in nine of them. Juvenile idiopathic arthritis was the most identifiable cause of uveitis, with anterior uveitis (50%) being the most frequent subtype of inflammation among these children. The median duration of immunosuppressive treatment before switching to tofacitinib was 18 (16–49) months. Remission of uveitis was achieved in all but two children, who experienced recurrence – manifesting as anterior uveitis. The median duration of follow-up in these children after tofacitinib treatment was 277.5 (183–549) days. At the end of follow-up, topical steroids could be withdrawn in six children, and two children were on topical steroids once a day. None of the children developed any systemic side-effect during the follow-up period. The mean BCVA at presentation was 0.62 ± 0.55, which improved to a mean of 0.27 ± 0.325 at the final follow-up (p = 0.0014)Conclusion Treatment of pediatric uveitis with tofacitinib can be a valuable second-line treatment option and useful alternative in low- and middle-income countries.