Ophthalmol Ther. 2025 Nov 23. doi: 10.1007/s40123-025-01275-z. Online ahead of print.
ABSTRACT
INTRODUCTION: Pediatric patients with noninfectious uveitis refractory to standard therapies have limited options. Efficacy and safety of systemic tacrolimus, a calcineurin inhibitor used successfully in adult noninfectious uveitis as an adjuvant immunomodulatory treatment, was investigated in the pediatric population at our institution.
METHODS: This was a retrospective chart review of patients ≤ 18 years old diagnosed with noninfectious uveitis who were intolerant to or failed conventional systemic immunosuppressants between January 2014 and June 2025 at a tertiary referral center. The primary outcome was treatment success, defined as two or more of the following: ≤ 0.5+ anterior chamber cell, ≤ 2 drops of topical steroids per day per eye, improvement or resolution of vitritis, macular edema, papillitis, and angiographic leakage without addition of systemic therapy at 6 and 12 months after tacrolimus initiation. Secondary outcomes included need for dose reduction or discontinuation owing to adverse effects. Descriptive statistics were used to analyze the data.
RESULTS: Data from 11 patients, with median age of 10 years, were analyzed. Treatment success was achieved in 88.9% and 63.6% of patients at 6 and 12 months, respectively. Although seven patients experienced laboratory abnormalities, tacrolimus was not discontinued. An average tacrolimus dose of 0.16 mg/kg/day divided every 12 h achieved therapeutic tacrolimus levels. Median duration (range) of tacrolimus therapy was 24 months (4-93 months).
CONCLUSIONS: Tacrolimus may potentially be a well-tolerated, safe, and effective option for refractory cases of pediatric noninfectious uveitis.
PMID:41275437 | DOI:10.1007/s40123-025-01275-z
