C Bottin1,2, A Fel1,2, N Butel1,2, F Domont3,4, A L Remond1,2, L Savey3,4, V Touitou1,2, J F Alexandra5, P LeHoang1,2, P Cacoub3,4, B Bodaghi1,2, D Saadoun3,4. 1. a Department of Ophthalmology , Pitie-Salpetriere Hospital , Paris , France. 2. b Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap , Universite Paris VI-Pierre et Marie Curie , Paris , France. 3. c Department of Internal Medicine and Clinical Immunology , Pitie-Salpetriere Hospital , Paris , France. 4. d DHU Inflammation, Immunopathologie, Biotherapie , Universite Paris VI-Pierre et Marie Curie , Paris , France. 5. e Department of Internal Medicine , Bichat Hospital , Paris , France.
Abstract
PURPOSE: This study aimed to evaluate the safety and efficacy of anakinra for severe and refractory scleritis. METHODS: Ten patients with severe (i.e. at least 2 ocular relapses per year despite treatment) and refractory [i.e. at least to one disease modifying antirheumatic drugs (DMARDS)] scleritis were treated with anakinra (100 mg/day subcutaneously). Scleritis was associated with inflammatory systemic diseases in 60% of cases. The remission rate defined the primary outcome. RESULTS: Ninety percent of patients were complete responders with a mean follow-up of 19.4 months after starting anakinra. The corticosteroids daily dose decreased from 18.3 ± 4.1 mg to 4.2 ± 4.9 mg, (p < 0.05), at initiation of anakinra and at end of follow-up, respectively. Associated immunosuppressants were stopped in all cases except one. Side effects were observed in 4 patients who did not need anakinra withdrawal. CONCLUSIONS: This pilot study suggests the efficacy of anakinra in patients with refractory scleritis.
PURPOSE: This study aimed to evaluate the safety and efficacy of anakinra for severe and refractory scleritis. METHODS: Ten patients with severe (i.e. at least 2 ocular relapses per year despite treatment) and refractory [i.e. at least to one disease modifying antirheumatic drugs (DMARDS)] scleritis were treated with anakinra (100 mg/day subcutaneously). Scleritis was associated with inflammatory systemic diseases in 60% of cases. The remission rate defined the primary outcome. RESULTS: Ninety percent of patients were complete responders with a mean follow-up of 19.4 months after starting anakinra. The corticosteroids daily dose decreased from 18.3 ± 4.1 mg to 4.2 ± 4.9 mg, (p < 0.05), at initiation of anakinra and at end of follow-up, respectively. Associated immunosuppressants were stopped in all cases except one. Side effects were observed in 4 patients who did not need anakinra withdrawal. CONCLUSIONS: This pilot study suggests the efficacy of anakinra in patients with refractory scleritis.
Authors: Trusha Patel; Sarah E Henrickson; Emily K Moser; Natania S Field; Kelly Maurer; Noor Dawany; Maire Conrad; Nancy Bunin; Jason L Freedman; Jennifer Heimall; Danielle E Arnold; Jing Wang; Jonathan E Markowitz; Sarah Beth Payne-Poff; Kelli W Williams; Pierre A Russo; E John Wherry; Marcella Devoto; Paula Oliver; Kathleen E Sullivan; Judith R Kelsen Journal: J Allergy Clin Immunol Pract Date: 2021-04-21