{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:59:46Z","timestamp":1773788386791,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Pediatric uveitis is the leading cause of acquired child blindness, due to unremitting inflammation and long-term steroid exposition. Biotherapies with anti-tumor necrosis factor alpha (anti-TNF\u03b1) are effective in controlling inflammation for severe pediatric uveitis in recent studies. Major concern of anti-TNF\u03b1 prescription is the balance between the severity of the disease and side effects of the drug. The aim of the present study is to describe a cohort of children with severe uveitis and to highlight the risk factors for a pejorative development that led to the prescription of anti-TNF\u03b1 drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective case-control study was carried out on children with uveitis associated with systemic inflammatory disease or idiopathic uveitis, with a minimum follow-up of 5 years. Anti-TNF\u03b1-treated patients (case) were studied and compared with patients who were not requiring anti-TNF\u03b1 (control). Univariate logistic regression analyses were performed to compare both groups and determine the risk factors for anti-TNF\u03b1 therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy-three cases of pediatric uveitis were included, 13 cases and 60 controls. The risk factors associated with increased odds of anti-TNF\u03b1 therapy were initial systemic disorder associated with uveitis [OR = 11.22 (1.37\u201391.85), <jats:italic>p<\/jats:italic> = 0.0241), family history of autoimmune diseases [OR = 9.43 (2.27\u201339.15), <jats:italic>p<\/jats:italic> = 0.0020], uveitis diagnosis before the age of 6 [OR = 4.05 (1.16\u201314.13), <jats:italic>p<\/jats:italic> = 0.0284], eye surgery [OR = 26.22 (2.63\u2013261.77), <jats:italic>p<\/jats:italic> = 0.0054], ocular complications at the first slit lamp exam [OR = 67.11 (3.78\u20131191.69), <jats:italic>p<\/jats:italic> = 0.0042], low visual acuity at diagnosis (\u22650.3 logMAR) [OR = 11.76 (2.91\u201347.62), <jats:italic>p<\/jats:italic> = 0.0005] and especially low binocular acuity at diagnosis (\u22650.3 logMAR) [OR = 8.75 (1.93\u201339.57), <jats:italic>p<\/jats:italic> = 0.0048], panuveitis [OR = 9.17 (2.23\u201337.60), <jats:italic>p<\/jats:italic> = 0.0021], having positive ANA [OR = 3.89 (1.07\u201314.11), <jats:italic>p<\/jats:italic> = 0.0391], and positive HLA B27 [OR = 9.43 (2.27\u201339.16), <jats:italic>p<\/jats:italic> = 0.0020].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Those risk factors could be used to establish a new follow-up and treatment schedule for severe uncontrolled uveitis. This could help to better predict the best time to start anti-TNF therapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.802977","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T06:39:36Z","timestamp":1646375976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk Factors Leading to Anti-TNF Alpha Therapies in Pediatric Severe 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