Background.
Infliximab (INF) has been shown to be beneficial in treating refractory
uveitis, however, no data exist on optimal dosing and the efficacy of higher dosing. Objectives. To compare the efficacy of low-dose (LD) (<10 mg/kg), moderate-dose (MD) (≥10-15 mg/kg), and high-dose (HD) INF (≥15-20 mg/kg) in the treatment of
uveitis. Methods. Retrospective chart review children with
uveitis diagnosed at Childrens Hospital Los Angeles and Millers Children's Hospital, CA, USA. Results. Of the 34 INF-treated children, 6 patients received LD, 19 received MD, and 9 received HD. Average disease duration prior to
therapy was 10.6, 24.6, and 37.1 months each group, respectively. Topical
steroids were discontinued after an average of 3 months, 9.5 months, and 10.2 months in the LD, MD, and HD groups, respectively. We found that 66% of patients receiving LD, 42% of MD, and 66% receiving HD INF failed
therapy and required either dose escalation or alternate medication for disease control. Conclusions. INF is beneficial in the treatment of
uveitis, and dose escalation up to 4 times above the approved dose is often necessary to achieve disease control in patients with
uveitis. Doses < 10 mg/kg every 4 weeks may not be sufficient to control disease.