Adalimumab in the treatment of recurrent idiopathic bilateral nodular scleritis

Bawazeer, Ahmed; Raffa, Lina

doi:10.4103/0974-620x.91271

Cited by 15 publications

(10 citation statements)

References 7 publications

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“…Adalimumab has been reported as successful in the treatment of bilateral idiopathic nodular scleritis (with no side effects reported) [ 8 ] and nodular scleritis associated with RA [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Refractory necrotizing scleritis successfully treated with adalimumab

Lawuyi¹,

Gurbaxani

2016

J Ophthal Inflamm Infect

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Necrotizing scleritis is the most severe and destructive form of scleritis with vision-threatening sequelae. It is divided into with inflammation and without inflammation (scleromalacia perforans). Adalimumab is a tumour necrosis factor (TNF)-inhibiting anti-inflammatory medication licensed for the treatment of rheumatoid and psoriatic arthritis, ankylosing spondylitis and inflammatory bowel disease (in the USA). We report two cases of necrotizing scleritis successfully treated with adalimumab.

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“…Adalimumab has been reported as successful in the treatment of bilateral idiopathic nodular scleritis (with no side effects reported) [ 8 ] and nodular scleritis associated with RA [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Refractory necrotizing scleritis successfully treated with adalimumab

Lawuyi¹,

Gurbaxani

2016

J Ophthal Inflamm Infect

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“…The first case reports and small case series of non-infectious scleritis successfully treated with adalimumab (ADA) [12][13][14][15][16] were followed by retrospective studies assessing its efficacy in larger samples of refractory patients [7,11,[17][18][19]. Ragam et al conducted a retrospective chart review of 17 patients with noninfectious, non-necrotizing scleritis and found that monoclonal anti-tumor necrosis factor alpha (TNFa) were able to reduce scleral inflammation and to concomitantly reduce the use of systemic GCs.…”

Section: Adalimumabmentioning

confidence: 99%

Biologic Therapies and Small Molecules for the Management of Non-Infectious Scleritis: A Narrative Review

et al. 2021

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Scleritis refers to a wide spectrum of ocular conditions ranging from mild to sight-threatening scleral inflammation that may compromise visual function and threaten the anatomical integrity of the ocular globe. Most aggressive forms like necrotizing or posterior scleritis are often difficult-to-treat cases, refractory to conventional treatment. The association with systemic diseases, namely rheumatoid arthritis, Sjögren syndrome, granulomatosis with polyangiitis, and relapsing polychondritis, may have prognostic implications as well. A better understanding of the pathogenesis of ocular inflammatory diseases have paved the way to more effective and targeted treatment approaches. In this regard, a growing body of evidence supports the potential role of biologic agents in the management of non-infectious scleral inflammation, either idiopathic or in a background of immune-mediated systemic disorders. Biologic agents such as anti-tumor necrosis factor agents, interleukin-1 and interleukin-6 inhibitors as well as CD20 blockade have displayed promising results. More specifically, several studies have reported their ability to control scleral inflammation, reduce the overall scleritis relapses, and allow a glucocorticoid-sparing effect while being generally well tolerated. Anecdotal reports have also been described with other biologic agents including abatacept, ustekinumab, daclizumab, and alemtuzumab as well as targeted small molecules such as tofacitinib. Further studies are warranted to fully elucidate the role of biologic agents in non-infectious scleritis and investigate specific areas with the aim to administer treatments in the context of personalized medicine. This review summarizes the available data regarding clinical trials, small pilot studies, and real-life experience of the last two decades reporting the use of biologic agents in the management of non-infectious scleritis.

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“…101 There are a few case reports of its use in refractory scleritis with good effect. 102, 103 Given the class effect, it is likely that adalimumab would be effective in larger series as well, though further data are needed to verify a treatment effect. A rare hepatosplenic lymphoma has been reported mostly in children receiving both adalimumab or other TNF inhibitor and azathioprine 104 .…”

Section: Current Opinionsmentioning

confidence: 99%

Pharmacotherapy of scleritis: current paradigms and future directions

Beardsley

Suhler

Rosenbaum

et al. 2013

Expert Opinion on Pharmacotherapy

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Introduction Scleritis is an inflammatory condition affecting the eye wall that may be associated with a number of systemic inflammatory diseases. Because scleritis can be refractory to standard treatment, knowledge of the body of available and emerging therapies is paramount and is reviewed here. Areas Covered This review focuses on both traditional and emerging therapies for non-infectious scleritis. We will cover the mechanisms of action and potential adverse effects of each of the treatment modalities. Additionally, a summary of the significant MEDLINE indexed literature under the subject heading “scleritis,” “treatment,” “immunomodulator” will be provided on each therapy, including commentary on appropriate use and relative contraindications. Lastly, novel treatments and potential drug candidates that are currently being evaluated in clinical trials with therapeutic potential will also be reviewed. Expert Opinion While oral non-steroidal anti-inflammatory drugs (NSAIDs) and oral corticosteroids are widely used, effective, first-line agents for inflammatory scleritis, refractory cases require anti-metabolites, T cell inhibitors, or biologic response modifiers. In particular, there is emerging evidence for the use of targeted biologic response modifiers, and potentially, for local drug delivery.

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Adalimumab in the treatment of recurrent idiopathic bilateral nodular scleritis

Cited by 15 publications

References 7 publications

Refractory necrotizing scleritis successfully treated with adalimumab

Refractory necrotizing scleritis successfully treated with adalimumab

Biologic Therapies and Small Molecules for the Management of Non-Infectious Scleritis: A Narrative Review

Pharmacotherapy of scleritis: current paradigms and future directions

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