In tubulointerstitial nephritis and uveitis (TINU) syndrome, anterior uveitis is a key ocular feature. Around two-thirds of patients with TINU and anterior uveitis do not achieve an adequate response with topical therapy alone and require escalation to a more intensive treatment approach.
This protocol applies to patients with TINU syndrome who present with anterior uveitis and in whom topical corticosteroids applied to the eye have not produced a sufficient response of ocular inflammation.
Prior therapy: Topical corticosteroids to the eye.
Target not achieved: Response of ocular inflammation to topical corticosteroids was insufficient, prompting escalation to this protocol.
Systemic corticosteroid therapy is the basis of the treatment approach for patients in this scenario. The full protocol — including agent selection, sequencing, monitoring, and individual considerations — is available via the link below.
Prompt resolution of ocular inflammation and renal recovery.
In the acute phase, around 1/3 of patients with TINU who have anterior uveitis will respond to topical corticosteroids, whereas 2/3 will require systemic corticosteroids (median duration of treatment is 2.5 months).
Ocular inflammation and renal function respond promptly to corticosteroid treatment during active disease, but maintaining quiescence in the eye can be more difficult than in the kidney.
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