PMID- 35673349
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221012
IS  - 1177-5467 (Print)
IS  - 1177-5483 (Electronic)
IS  - 1177-5467 (Linking)
VI  - 16
DP  - 2022
TI  - Safety of Intravenous Methylprednisolone in Refractory and Severe Pediatric 
      Uveitis.
PG  - 1697-1706
LID - 10.2147/OPTH.S366370 [doi]
AB  - PURPOSE: To evaluate the safety of intravenous high-dose pulse methylprednisolone 
      succinate (IVHDM) in the management of severe or refractory non-infectious 
      pediatric uveitis. METHODS: We reviewed all uveitis patients who were </=16 years 
      of age and who received IVHDM with a dose of >/=500 mg per day (1-3 days a month) 
      for at least 3 months during their management at a tertiary care eye hospital. 
      RESULTS: Twenty pediatric patients with severe or refractory uveitis who received 
      IVHDM were identified. Six patients received IVHDM either once, as a preoperative 
      medication, or at a lower dose than 500 mg, and were excluded. The remaining 14 
      patients received IVHDM for at least 4 months. Age (mean+/-SD) was 11.9+/-2.4 years 
      and 50% were female. Duration of treatment was 14.2+/-7.5 months. Thirteen patients 
      received IVHDM in combination with other immunomodulatory therapy (IMT). Except 
      for two outliers, IVHDM was given at a dose of 8-25 mg/kg per infusion. Three 
      major adverse events (AEs) occurred in two patients: a single episode of 
      bradycardia, compression fracture following minor trauma and adrenal 
      insufficiency. The number of AEs (major and minor) strongly correlated with 
      duration of treatment (p=0.004) and moderately correlated with the cumulative 
      dose/weight (p=0.051). Weight gain was associated with the use of concomitant 
      oral steroids and not with duration of treatment or cumulative dose. CONCLUSION: 
      IVHDM may be a valid therapeutic option for aggressive/refractory pediatric 
      uveitis. The reported AEs in this series can also be attributed to the concurrent 
      IMT or the underlying disease itself.
CI  - (c) 2022 Ghoraba et al.
FAU - Ghoraba, Hashem H
AU  - Ghoraba HH
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Matsumiya, Wataru
AU  - Matsumiya W
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
AD  - Department of Surgery, Division of Ophthalmology, Kobe University Graduate School 
      of Medicine, Kobe, Japan.
FAU - Khojasteh, Hassan
AU  - Khojasteh H
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Akhavanrezayat, Amir
AU  - Akhavanrezayat A
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Karaca, Irmak
AU  - Karaca I
AUID- ORCID: 0000-0001-7927-0887
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Or, Christopher
AU  - Or C
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Yavari, Negin
AU  - Yavari N
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Lajevardi, Sherin
AU  - Lajevardi S
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Hwang, Jaclyn
AU  - Hwang J
AUID- ORCID: 0000-0001-7756-3918
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Yasar, Cigdem
AU  - Yasar C
AUID- ORCID: 0000-0003-0386-3613
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Do, Diana
AU  - Do D
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
FAU - Nguyen, Quan Dong
AU  - Nguyen QD
AD  - Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 
      Palo Alto, CA, USA.
LA  - eng
GR  - P30 EY026877/EY/NEI NIH HHS/United States
PT  - Journal Article
DEP - 20220531
PL  - New Zealand
TA  - Clin Ophthalmol
JT  - Clinical ophthalmology (Auckland, N.Z.)
JID - 101321512
PMC - PMC9167570
OTO - NOTNLM
OT  - adverse events
OT  - intravenous methylprednisolone
OT  - pediatric uveitis
COIS- Prof. Dr. Diana Do reports grants and personal fees from Regeneron, and personal 
      fees from Genentech, outside the submitted work. Prof. Dr. Quan Dong Nguyen 
      reports grants and personal fees from Genentech, personal fees from Bausch and 
      Lomb, grants and personal fees from Regeneron, grants and personal fees from 
      Novartis, and grants and personal fees from Santen, outside the submitted work. 
      The authors report no conflict of interest in this work.
EDAT- 2022/06/09 06:00
MHDA- 2022/06/09 06:01
PMCR- 2022/05/31
CRDT- 2022/06/08 01:55
PHST- 2022/03/16 00:00 [received]
PHST- 2022/05/10 00:00 [accepted]
PHST- 2022/06/08 01:55 [entrez]
PHST- 2022/06/09 06:00 [pubmed]
PHST- 2022/06/09 06:01 [medline]
PHST- 2022/05/31 00:00 [pmc-release]
AID - 366370 [pii]
AID - 10.2147/OPTH.S366370 [doi]
PST - epublish
SO  - Clin Ophthalmol. 2022 May 31;16:1697-1706. doi: 10.2147/OPTH.S366370. eCollection 
      2022.