Infliximab Therapy for the Treatment of Refractory Ocular Inflammatory Disease

Abstract

To report the outcomes of infliximab therapy in the treatment of ocular inflammatory disease refractory to traditional immunomodulatory therapy (IMT). Methods:We retrospectively reviewed the medical records of 27 patients. All patients had noninfectious ocular inflammatory disease refractory to traditional IMT and received 5 mg/kg of infliximab at 2-week to 8-week intervals. Main outcome measures were clinical response, reduction in concomitant IMT, and adverse effects. Cumulative incidences of inflammation control and vision change were calculated using life-table methods.Results: Twenty-one patients experienced sustained improvement in inflammation with their initial course of infliximab therapy. Cumulative incidence of inflammation resolution at 12 months was greater than 90%. Sixteen patients were able to decrease the dose of their concomitant IMT medication or stop all other IMT. Four patients were able to discontinue all other IMT while receiving infliximab therapy. Three patients with scleritis were eventually able to remain inflammation-free while not taking any medication. At 12 months, 56% and 65% of left and right eyes, respectively, showed visual acuity improvement by 2 or more Snellen lines. Only 1 patient developed an adverse event requiring therapy discontinuation. Conclusions:We found a high rate of ocular inflammation control with infliximab therapy. The incidence of adverse effects in this study was low.

Posterior Necrotizing Scleritis Presenting as Sectoral Chorioretinitis

“…[9][10][11] The patient has to date received 5 infliximab infusions and has been tapered off prednisone. Her vision and inflammation have remained stable for 3 months off of prednisone; her pain is slowly improving (Figure 1H).…”

Prevalence and characteristics of eye involvement in patients with rheumatoid arthritis

“…Data were analyzed using the statistical package for the social sciences (version 19). Chi square test of association was used to compare between proportions.…”

“…11,18 According to use of DMARD alone or DMARD and Biological Agents as a treatment for articular and extra-articular manifestations in RA patients, we found that there is no statistical significance relationship between the curable effects of them and ocular manifestations in RA patient, while studies were done by Gordana Zlatanović et al and others show that (DMARDs) are necessary to improve tear production and to resolve severe ocular complications in RA patients like Cyclosporine A, or a monoclonal antibody to TNF-alpha such as infliximab. 19,21 …”

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

“…[29][30][31] Vogt-Kayanagi-Harada (VGH) hastal›¤›, JIA, sklerit, ankilozan spondilit, psoriazis gibi çok farkl› etyolojilere ba¤l› intraoküler inflamasyonlar›n infliksimab ile kontrol edilebildi¤i bildirilmifltir. [32][33][34][35][36][37] Ayr›ca farkl› endikasyonlarla non-enfektif intraoküler inflamasyonu bulunan olgularda ilac›n intravitreal uyguland›¤›nda makula öde-minde ve görme keskinli¤i üzerine anlaml› olumlu etkisi oldu¤u gösterilmifltir. 38 Ancak diabetik makula öde-mi veya yafla ba¤l› makula dejeneresans› olgular›nda intravitreal infliksimab enjeksiyonunun iyi tolere edilemedi¤i ve retinaya toksik etkisinin oldu¤u bildirilmifltir.…”