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Effectiveness of TNF-α blockade in the treatment of refractory non-infectious scleritis: a multicentre study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
  2. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  3. Clinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Spain.
  4. Clinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Spain.
  5. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  6. Rheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy.
  7. Rheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy.
  8. Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Italy.
  9. Department of Ophthalmology and Otolaryngology, University of Bari, Italy.
  10. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  11. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
  12. Vasculitis Research Unit and Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Spain.
  13. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. cantariniluca@hotmail.com

CER12631
2020 Vol.38, N°6
PI 1138, PF 1144
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PMID: 32301435 [PubMed]

Received: 25/07/2019
Accepted : 17/01/2020
In Press: 17/04/2020
Published: 03/12/2020

Abstract

OBJECTIVES:
To evaluate the efficacy of tumour necrosis factor (TNF)-α inhibitors in refractory non-infectious scleritis.
METHODS:
We carried out a retrospective study assessing the efficacy of TNF-α inhibitors in the treatment of scleritis, scleritis relapses, glucocorticoid (GC)-sparing effect, impact on best-corrected visual acuity (BCVA) and safety profile.
RESULTS:
Nineteen patients (28 eyes) were eligible for analysis. Scleritis inflammatory grading significantly improved from baseline to the last follow-up (median ± IQR 2±4 and 0±0 respectively, p=0.0006). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.001). Mean GC dosage decreased from baseline (19.00±13.56 mg) to the last follow-up (7.59±5.56 mg) (p=0.003). No significant differences regarding BCVA were observed. Two AEs were recorded (1 severe urticaria and 1 case of pneumonia and paradoxical psoriasis).
CONCLUSIONS:
TNF-α inhibitors are effective in the treatment of scleritis while allowing a GC-sparing effect and preserving BCVA.

Rheumatology Article