Adalimumab for Mooren's Ulcer

Management of severe and refractory Mooren's ulcers with rituximab

“…Systemic treatments such as cyclophosphamide, methotrexate and corticosteroids have been shown to be effective in cases series. Recently, anti-tumour necrosis factor agents were effective in a case report 10 11. For severe cases, cyclophosphamide is recommended as the first-line treatment in association with conjunctival resection, cyanoacrylate application or lamellar keratoplasty6 in order to avoid the occurrence of perforation 3.…”

Immunosuppression for Mooren's ulcer: evaluation of the stepladder approach—topical, oral and intravenous immunosuppressive agents

“…With use of systemic oral immunosuppression, the success rate for disease cure was 78%. A number of immunomodulators have been used by few authors for treatment of Mooren's ulcer such as cyclophosphamide,4 azathioprine,7 adalimumab5 and oral cyclosporine 9. However, we chose to use methotrexate in our patients due to the relative safety profile, better efficacy in a few systemic trials, once a week dosage improving compliance and lower cost than other immunomodulators 10–12…”

Adalimumab for refractory peripheral ulcerative keratitis

“…TNF-α has been demonstrated to be one of the main pro-inflammatory molecules causing and/or perpetuating the PUK process [4]. In this sense, we have reported promising results when using adalimumab for Mooren's ulcer [5]. TNF-α blockers in general may be a good therapeutic option for these patients based not only in their anti-inflammatory effects, but they may also act as "remodeling" agents as observed in other diseases, such as rheumatoid arthritis, in which these agents contribute to modulate systemic and local bone resorption and reduce cartilage degradation [6].…”