Anti-Tumor Necrosis Factor-α Agents in Noninfectious Uveitis

Gueudry, J.; LeHoang, Phuc; Bodaghi, Bahram

doi:10.1159/000336187

Cited by 12 publications

(9 citation statements)

References 97 publications

(126 reference statements)

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“…Oral glucocorticoids are reserved for patients with bilateral disease or for patients who do not respond to topical medications. The role of tumor necrosis factor-alpha (TNF-α) inhibitors in the treatment of patients with uveitis is being investigated [11]; these inhibitors appear to be more effective than corticosteroids in some patients with noninfectious uveitis [12]. In the case of metastatic melanoma, resolution of symptoms is pivotal to initiate a new line of treatment.…”

Section: Discussionmentioning

confidence: 99%

Severe pan-uveitis in a patient treated with vemurafenib for metastatic melanoma

et al. 2013

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BackgroundVemurafenib, an inhibitor of genetically activated BRAF, is now commonly prescribed for metastatic melanoma harboring a BRAF mutation. Reports on side effects have focused on cutaneous complications. We here present a case of a severe pan-uveitis associated with vemurafenib use.Case presentationA 63-year old female was treated with the BRAF inhibitor vemurafenib for metastatic melanoma. After seven weeks of treatment, she developed near-complete visual loss in the course of a few days, as a result of severe uveitis. Vemurafenib had to be discontinued and systemic and topical corticosteroids were initiated. The visual symptoms improved slowly, however the cerebral metastases progressed and the patient died from her disease.ConclusionTreatment with vemurafenib has become an important component of standard clinical care for patients with metastatic melanoma. In addition, it is one of the best examples of genotype-directed therapy. This case illustrates that vemurafenib-induced uveitis can develop fast and be slow to resolve. Awareness of this potentially severe side effect is of major importance to oncologists and aggressive treatment should be considered.

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Section: Discussionmentioning

confidence: 99%

Severe pan-uveitis in a patient treated with vemurafenib for metastatic melanoma

et al. 2013

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“…Furthermore, given collective clinical experience in uveitis and other conditions, switching between anti-TNFα therapies appears to be efficient and safe in cases of primary or secondary failure permitting to prolong their use. 83 It is however necessary to note that a meta-analysis published by Wu et al 84 from six selected randomized controlled trials 38,[85][86][87][88] shows contradictory results. In this study, 663 patients "etanercept vs placebo" and 436 patients "monoclonal anti-TNFα antibodies vs placebo" were analyzed.…”

Section: Anti-tnfα Agents In Preventing Hla-b27 Uveitis Relapsesmentioning

confidence: 99%

Biologic Therapy for HLA-B27-associated Ocular Disorders

Gueudry

Thorne

Bansie

et al. 2016

Ocular Immunology and Inflammation

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The treatment of articular and extra-articular manifestations associated with HLA-B27 has undergone dramatic changes over the past two decades, mainly as a consequence of the introduction of biologic agents and in particular anti-tumor necrosis factor α (anti-TNFα) agents. Uveitis is known to be the most frequent extra-articular feature in HLA-B27-associated spondyloarthritides. Topical corticosteroids and cycloplegic agents remain the cornerstones of treatment. However, biologic therapy may be effective in the management of refractory or recurrent forms of uveitis. This review gives an update on the management of HLA-B27-associated ocular disorders with biologics, including anti-TNFα agents and non-anti-TNFα biologic modifier drugs. There is an emerging role for newer biologics targeting interleukin-12/23 and interleukin-17 for the treatment of spondyloarthritides but data on their efficacy on anterior uveitis are sparse.

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“…Etanercept is a fusion protein, which is a soluble receptor binding soluble TNFα and preventing it from binding to target cells. Etanercept has lower efficacy for uveitis treatment than anti-TNFα antibodies [ 97 ].…”

Section: Treatment Modalities and Perspectivesmentioning

confidence: 99%

Old and New Challenges in Uveitis Associated with Behçet’s Disease

Gueudry

Leclercq

Saadoun

et al. 2021

JCM

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Behçet’s disease (BD) is a systemic vasculitis disease of unknown origin occurring in young people, which can be venous, arterial or both, classically occlusive. Ocular involvement is particularly frequent and severe; vascular occlusion secondary to retinal vasculitis may lead to rapid and severe loss of vision. Biologics have transformed the management of intraocular inflammation. However, the diagnosis of BD is still a major challenge. In the absence of a reliable biological marker, diagnosis is based on clinical diagnostic criteria and may be delayed after the appearance of the onset sign. However, therapeutic management of BD needs to be introduced early in order to control inflammation, to preserve visual function and to limit irreversible structural damage. The aim of this review is to provide current data on how innovations in clinical evaluation, investigations and treatments were able to improve the prognosis of uveitis associated with BD.

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Anti-Tumor Necrosis Factor-α Agents in Noninfectious Uveitis

Cited by 12 publications

References 97 publications

Severe pan-uveitis in a patient treated with vemurafenib for metastatic melanoma

Severe pan-uveitis in a patient treated with vemurafenib for metastatic melanoma

Biologic Therapy for HLA-B27-associated Ocular Disorders

Old and New Challenges in Uveitis Associated with Behçet’s Disease

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