Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease

Smith, Justine R.; Levinson, Ralph D.; Holland, Gary N.; Jabs, Douglas A.; Robinson, Michael R.; Whitcup, Scott M.; Rosenbaum, James T.

doi:10.1002/1529-0131(200106)45:3<252::aid-art257>3.0.co;2-5

Cited by 304 publications

(60 citation statements)

References 18 publications

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“…[53][54][55][56][57][58][59][60][61][62] Approximately 25%-30% of AS patients may develop uveitis. Only a small number of patients had severe and recurrent attacks of anterior uveitis, for which steroid or salazopyrin failed.…”

Section: Discussionmentioning

confidence: 99%

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The clinical application of etanercept in Chinese patients with rheumatic diseases

Chou

2006

Mod Rheumatol

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Over a 2-year period, to evaluate the efficacy and safety of biologic agents, etanercept (25 mg twice per week, s.c.) was used to treat 57 rheumatoid arthritis (RA) patients, 9 ankylosing spondylitis (AS) patients, 6 psoriatic arthritis (PSA) patients, and 4 juvenile rheumatoid arthritis (JRA) patients. In addition to inflammatory arthritis, I have used this tumor necrosis factor (TNF) blocker in other rheumatic diseases including idiopathic thrombocytopenic purpura (ITP), Behçet's disease with intractable oral ulcer, fibromyalgia syndrome, and systemic lupus erythematosis with intractable pleural effusion and acute lumbar disc herniation. For RA, after 6 months of etanercept treatment, all the parameters including number of swollen joints, number of tender joints, disease activity score, erythrocyte sedimentation rate, C-reactive protein, and global health status were rapidly improved (P < 0.001 or P < 0.0001). The anticyclic citrullinated peptide (anti-CCP) antibody and rheumatoid factor also significantly declined. For spondyloarthropathy, it also gave a similar effect as to RA. Both Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index also improved. One of the two cases with Behçet's disease with intractable oral ulcer had a long-term remission after etanercept. The other Behçet's disease patient with oral ulcer and another with ITP obtained a good response temporarily. The short-term use of etanercept (<3 months) did not bring a significant effect for cases of fibromyalgia syndrome, pleural effusion, and lumbar disc herniation. In conclusion, a dramatic and rapid clinical response in different kinds of arthritis patients can be achieved by etanercept. Moreover, the TNF-alpha inhibitor also can treat other severe rheumatic-related symptoms. In general, except for a few cases with infection and two cases with malignancy, etanercept was safe in our arthritis patients. We need to study a larger number of patients in order to better understand the efficacy and safety of etanercept.

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Section: Discussionmentioning

confidence: 99%

“…For severe refractory uveitis either from AS or panuveitis from Behçet's disease, TNF-α blockers have been used successfully. 62 For Crohn's disease, etanercept is not approved by the FDA. In contrast, infliximab has been proven to be efficacious in the treatment of Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

The clinical application of etanercept in Chinese patients with rheumatic diseases

Chou

2006

Mod Rheumatol

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“…Other reports suggested the success of this drug therapy in dealing with orogenital ulcers and gastrointestinal BD [456,457,478]. However, controversy exists about its role in concomitant joint involvement, which would suggest a difference in the pathogenic mechanisms in both organs [479].…”

Section: Anti-inflammatory Cytokine Therapymentioning

confidence: 99%

Behcet’s disease

Al-Mutawa¹,

Hegab

2004

Clin Exp Med

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Behcet's disease is a recurrent multisystem vasculitis that can affect any organ or system, but was originally described as orogenital ulcerations and uveitis. Specific criteria have been proposed for diagnosis and identification of affected organs by different national authorities. Behcet's disease is proposed to be due to an antigen/antibody reaction. The antigen can be external (microbial or other) or self-antigen. Self-antigens include HLA-B, S and interphotoreceptor retinoid binding protein, the oral mucosal antigens, and alphatropomycin. The antibody reaction manifests as changes common to any inflammatory process. Circulating immune complexes and neutrophil hyperactivity are present with the expression of adhesion molecules related to disease activity associated with phenotypic and functional aberrations affecting both Th1 and Th2 activity. The results in an increase of interleukin-4, -10, and -1B and interleukin-2 receptors with deficient interleukin-12, interferon-gamma, and expression of cell adhesion CDII/CD18, accompanied by increased B cells secreting IgG. The clinical picture varies according to the organ affected; emphasis is placed on those of diagnostic importance and those affecting morbidity and mortality. The histopathology demonstrates vasculitis with inflammatory cell infiltration, the endothelium expressing ICAM-1 and E-selectin, vascular occlusion with sequences. Treatment includes corticosteroids. Other immunosuppressant and biological agents include anti-tumor necrosis factor, interferon-alpha, Campath-1, and the S antigen. Colchicine and other miscellaneous therapies are included.

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“…Eine frühe Studie an Patienten mit rheumatischer Erkrankung und entzündlicher Augenerkrankung, die fast ausschließlich mit Etanercept behandelt wurden, zeigte ein gutes Ansprechen der Gelenke bei allen betroffenen Patienten, aber nur bei 38% der Patienten eine Besserung der Augenentzündung [31].…”

Section: Therapie Bei Häufigen Schübenunclassified

Augenbeteiligung bei Spondyloarthritiden

2010

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The most frequent extraarticular manifestation in spondyloarthropathies (SpA) is eye involvement, which is found in 30%-50% of patients. HLA B27 positive patients in particular--mostly those in the subgroup with ankylosing spondylitis--are affected. Prevalence of uveitis increases with duration of disease. Typical eye involvement is sudden-onset unilateral anterior uveitis (iridocyclitis). Most cases respond well to topical corticosteroids. Frequently relapsing or chronic cases may require oral corticosteroids in addition to classical immunosuppressive drugs and, to an increasing extent, also TNF-alpha inhibitors. In the case of the latter, monoclonal antibodies are preferred over receptor antagonists. Acute anterior uveitis may occur as a minimal variation or initial symptom of SpA. These patients should also be seen by a rheumatologist since undiagnosed SpA may be present in a significant percentage and should be included in therapeutic considerations.

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Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease

Cited by 304 publications

References 18 publications

The clinical application of etanercept in Chinese patients with rheumatic diseases

The clinical application of etanercept in Chinese patients with rheumatic diseases

Behcet’s disease

Augenbeteiligung bei Spondyloarthritiden

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