儿童葡萄膜炎是一种罕见但威胁视力的疾病。及时和充分的治疗对于保持视力和避免长期并发症至关重要。如果对皮质类固醇和缓解病情的抗风湿药物 (DMARD) 耐药，通常会添加抗肿瘤坏死 (抗 TNF) 生物制剂。在这项研究中，我们报告了在这组患者中使用阿达木单抗 (ADA) 抗 TNF 药物的经验。 这是一项在曼彻斯特皇家眼科医院三级儿科葡萄膜炎诊所进行的回顾性观察研究。所有患者均为接受为期六个月随访的儿科患者（年龄2-18岁）。根据诊断、葡萄膜炎发病年龄、ADA之前和同时使用的全身药物、开始ADA之前葡萄膜炎的持续时间、其效果以及注意到控制炎症的治疗效果的时间来分析患者的数据。最后，对抗药物抗体开发的案例进行了审查。 该研究包括四十二名患者。 47.6% 的患者被诊断为特发性葡萄膜炎，40.5% 的患者患有幼年特发性关节炎 (JIA)。大多数（97.6%）患者在开始 ADA 之前使用局部类固醇，95.2% 在确定 ADA 使用后继续使用类固醇，但全身类固醇使用从 33.3% 减少到 14.3%。 ADA 之前使用的最常见的非生物 DMARD 是甲氨蝶呤 (MTX) (90.5%)。三分之一的患者在葡萄膜炎诊断后 6 至 12 个月内开始使用 ADA，而这一比例在诊断后一年下降至 9.5%。 78% 的患者在使用 ADA 后获得了炎症的完全临床控制。近 78.6% 的患者在不到六个月的时间内表现出完全缓解。在 ADA 未控制或暂时控制的 8 名患者中，3 名患者的抗药物抗体呈阳性。一名患者在使用 ADA 12 年后发现了抗药物抗体，而另一名患者则在使用 4 年后发现了抗药物抗体。 阿达木单抗是一种有效、耐受性良好的药物，用于治疗非生物 DMARD 治疗难治性葡萄膜炎儿童。在该队列中，DMARD 通常与 ADA 一起使用，很少有患者确认有 ADA 抗体。版权所有 © 2024，Ghanma 等人。

 Pediatric uveitis is a rare but sight-threatening condition. Prompt and adequate treatment is crucial to preserve vision and avoid long-term complications. In cases that are resistant to corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs), anti-tumor necrosis (anti-TNF) biologic agents are usually added. In this study, we report our experience with adalimumab (ADA) anti-TNF use in this group of patients. This is a retrospective observational study conducted in a tertiary pediatric uveitis clinic, in Manchester Royal Eye Hospital. All patients were pediatric patients (aged 2-18 years old) under follow-up during the period of six months. The patients' data were analyzed according to the diagnosis, age of onset of uveitis, systemic medications used before and concomitantly with ADA, duration of uveitis before starting ADA, its effect, and time to notice the therapeutic effect in controlling inflammation. Finally, cases were reviewed for the development of anti-drug antibodies. Forty-two patients were included in the study. Idiopathic uveitis was diagnosed in 47.6% of patients and 40.5% of patients were associated with juvenile idiopathic arthritis (JIA). Most (97.6%) of patients were using topical steroids before starting ADA and 95.2% continued using steroids after established ADA use, but systemic steroid use was reduced from 33.3% to 14.3%. The most common non-biologic DMARD used before ADA was methotrexate (MTX) (90.5%). One-third of the patients started ADA between 6 and 12 months after the diagnosis of uveitis, while this percentage dropped to 9.5% the year after diagnosis. Seventy-eight percent of patients acquired complete clinical control of inflammation on ADA use. Almost 78.6% of patients showed a full response in less than six months. In eight patients who were not controlled or were transiently controlled on ADA, three patients had positive anti-drug antibodies. In one patient, antidrug antibodies were identified after 12 years of ADA use, and in another, after 4 years. Adalimumab is an effective, well-tolerated drug in children with uveitis refractory to non-biologic DMARD therapy. DMARDs were usually used alongside ADA in this cohort and few patients had confirmed ADA antibodies.Copyright © 2024, Ghanma et al.