Design and Interpretation of Clinic-Based Studies in Uveitis

Cunningham, Emmett T.; Acharya, Nisha R.; Kempen, John H.; Zierhut, Manfred

doi:10.3109/09273948.2015.1074028

Cited by 7 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several larger series provided overall cohort statistics only and so could not be incorporated into our calculations. Finally, the efficacy of the studies reviewed here may not reflect a broader population-based sample of refractory non-infectious/non-malignant orbital inflammation due to referral, selection, treatment, evaluator, and/or publication bias [ 72 ]. Safety and adverse events data was explicitly provided for fewer than half of cases.…”

Section: Discussionmentioning

confidence: 99%

Rituximab for treatment of non-infectious and non-malignant orbital inflammatory disease

Cunningham

2021

J Ophthal Inflamm Infect

Self Cite

View full text Add to dashboard Cite

Purpose To provide a comprehensive review of rituximab use for the treatment of non-infectious/non-malignant orbital inflammation. Methods Review of literature through January 2021. Results Individual data was available for 167 patients with refractory non-infectious/non-malignant orbital inflammation who received treatment with rituximab (RTX). Rituximab was generally utilized as third-line or later treatment (108/149, 72.5%) at a mean of 44.6 months following the diagnosis of orbital inflammation (range = 0 to 360 months; median = 13.7 months). Patients with non-infectious/non-malignant orbital inflammation either received prior treatment with corticosteroids only (27/122, 22.1%), or with one (31/122, 25.4%), two (25/122, 20.5%), or three or more (25/122, 20.5%) corticosteroid-sparing immunosuppressive agents with or without corticosteroids before initiation of RTX treatment. The rheumatologic protocol (two infusions of 1 gram of RTX separated by 14 days) was utilized most frequently (80/144, 55.6%), followed by the oncologic protocol (four weekly infusions of 375 mg/m2 RTX; 51/144, 35.4%). Various other off-label regimens were used infrequently (13/144, 9.0%). Rituximab treatments resulted in a positive therapeutic response for the majority of patients with orbital inflammation (146/166, 88.0%). Commonly treated diagnoses included granulomatosis with polyangiitis (99/167, 59.3%), IgG-4 related disease (36/167, 21.6%), and orbital inflammation of indeterminate cause (25/167, 15.0%). No side effects were reported in 83.3% (55/66) of cases. The most common RTX-induced adverse event was an infusion-related temporary exacerbation of orbital disease (4/66, 6.1%), which occurred prior to the routine use of systemic corticosteroids as pre-conditioning. Conclusions Overall, RTX appears to be both efficacious and well-tolerated as second- or third-line therapy for patients with non-infectious/non-malignant orbital inflammation.

show abstract

Section: Discussionmentioning

confidence: 99%

Rituximab for treatment of non-infectious and non-malignant orbital inflammatory disease

Cunningham

2021

J Ophthal Inflamm Infect

Self Cite

View full text Add to dashboard Cite

show abstract

“…The authors acknowledged the limitations inherent in the retrospective, single-center nature of their study cohort. 21 While the prevalence of ocular complications of both SLE and of glucocorticoids and HCQ were lower than reported in some clinic-based cohorts, perhaps related to increased use of noncorticosteroid immunosuppressive agents, the authors stressed the importance of both baseline and routine ophthalmologic examinations as part of the multidisciplinary approach to patients with this disorder.…”

mentioning

confidence: 92%

Systemic Lupus Erythematosus and the Eye

Cunningham

Tabbara

Zierhut

2018

Ocular Immunology and Inflammation

Self Cite

View full text Add to dashboard Cite

“…Identified imbalances in IFX-treated subjects included worse median baseline best-corrected visual acuity (BCVA; 20/56 vs. 20/28; p = 0.0078), and trends toward higher median daily corticosteroid dosage (12.5 vs. 10 mg/day; p = 0.035), longer median duration of treatment (18 vs. 12 months; p = 0.67), and higher median baseline central foveal thickness (CFT) as measured on optical coherence tomography (OCT; 469 vs. 382 microns; p = 0.43). These potential sources of bias and confounding acknowledged, 25 the authors reported that the proportion of eyes with a decrease in CFT of 50 microns or more following both 6 months--the primary outcome measure (ADA = 50% vs. IFX = 62%)--and 12 months (ADA = 50% vs. IFX = 56%) of treatment tended to be similar in the two subgroups. Changes from baseline to 6-month BCVA and corticosteroidsparing effect in ADA and IFX arms were small and similarly not statistically significant.…”

mentioning

confidence: 99%