Overall and cancer related mortality among patients with ocular inflammation treated with immunosuppressive drugs: retrospective cohort study

Abstract

Most commonly used immunosuppressive drugs do not seem to increase overall or cancer mortality. Our results suggesting that tumour necrosis factor inhibitors might increase mortality are less robust than the other findings; additional evidence is needed.

Current concepts and future directions in the pathogenesis and treatment of non-infectious intraocular inflammation

“…In a cohort study looking at over 66 802 person years of treatment it was noted that for the most commonly used immunosuppressive drugs there was no increase in overall or cancer mortality. 63,64 However, whether that is true for the biologics, which are in increasing use, will require longer follow-up and improved clinical outcome surveillance. Since the early reports of CAMPATH-1H, 65,66 most evidence for the success of biologics has accumulated using anti-TNF therapies, which have followed an iterative process of evidence for their efficacy in animal models, through to early phase studies, small RCTs and are now undergoing more definitive assessment in commercially-led RCTs.…”

Treatment of cystoid macular edema secondary to chronic non-infectious intermediate uveitis with an intraocular dexamethasone implant

“…The Systemic Immunosuppressive Therapy for Eye Diseases study recently reported data on both overall and cancer-related mortality following inflammatory disease treatment with immunosuppressants or biologic drugs (9) . Preliminary findings from this study have suggested that cancer and total mortality may increase with the use of anti-tumor necrosis factor agents, though this must be confirmed in further studies.…”

“…Preliminary findings from this study have suggested that cancer and total mortality may increase with the use of anti-tumor necrosis factor agents, though this must be confirmed in further studies. In addition to these safety concerns, biologic drugs also pose difficulties with respect to third-party payment and their overall cost (9,10) . For these reasons and due to the absence of solid medical evidence, biologic treatments may not be the treatment of choice for uveitis.…”

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

“…Sonuçlar TNF-antagonistlerinin her iki riski artt›rm›fl oldu¤unu göstersede, yazarlar sonuçlar›n› yorumlarken bu hastalarda efllik eden ciddi sistemik inflamasyonlar›n ve beraber kullan›lan siklofosfamid gibi ajanlar›n olas› etkilerinin gözden kaç›r›lmamas› gerekti¤ini bildirmifllerdir. 83 Farkl› araflt›rmac›lar RA hastalar›nda biyolojik ajanlar›n kullan›m›ndan sonra görülen artm›fl lenfoma riskinin hastal›¤›n do¤al seyri ile iliflkili oldu¤unu belirtmifllerdir. [80][81][82] Non-enfektif intraoküler inflamasyonlar›n kontrolünde biyolojik ajan kullan›lan hasta say›s›n›n azl›¤› ve genel olarak hasta yafllar›n›n RA hastalar›na göre çok daha genç olmas› sebebiyle bizim hasta grubumuzda bu konuda bir yorum yap›labilmesi için çok daha uzun süre takipli, genifl, homojen çal›flma gruplar›na ihtiyaç vard›r.…”