TNF-α blockers and demyelinating lesions in pediatric non-infectious uveitis: Insights from a real world cohort.
Central nervous system demyelinating lesions occurred in 8.8% of children on TNF-α blockers for uveitis.
TNF-α blockers and demyelinating lesions in pediatric non-infectious uveitis: Insights from a real world cohort.
To characterize childhood non-infectious uveitis (non-infectious uveitis) patients who developed demyelinating lesions during TNF-α blocker therapy and to investigate potential risk factors associated with this pathology.
This retrospective single-center cohort study included pediatric non-infectious uveitis patients treated with TNF-α blockers who had undergone brain magnetic resonance imaging (magnetic resonance imaging) at any time during the course of the disease.
The study cohort included 45 patients with a mean age of 13.8±4.46 (5-22) years.
The mean duration of TNF-α blocker treatment within the study period was 44±27.9 months.
The ocular complication score did not significantly change from baseline to final visit (P=0.10).
All demyelinating lesions were detected on MRIs obtained after TNF-α blocker initiation (median: 52 months; range 18-84).
Central nervous system demyelination was uncommon but clinically relevant in pediatric non-infectious uveitis patients receiving TNF-α blockers.
Demyelinating lesions may be associated with pars planitis, neurologic symptoms, and/or a family history of demyelinating disease.
During treatment, central nervous system magnetic resonance imaging may be considered when new neurologic symptoms accompany an uncontrolled uveitis flare, particularly in the presence of newly developed ocular inflammatory findings.