Claudia Fabiani1, Antonio Vitale2, Donato Rigante3, Giacomo Emmi4, Giuseppe Lopalco5, Jurgen Sota2, Lorenzo Vannozzi6, Silvana Guerriero7, Alice Bitossi6, Ida Orlando2, Rossella Franceschini8, Bruno Frediani2, Mauro Galeazzi2, Florenzo Iannone5, Gian Marco Tosi8, Luca Cantarini9. 1. Department of Ophthalmology, Humanitas Clinical and Research Centre, Rozzano, Milan; and Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy. claudia.fabiani@gmail.com. 2. Research Centre of Systemic Autoinflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. 3. Institute of Paediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy. 4. Department of Experimental and Clinical Medicine, University of Florence, Italy. 5. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Italy. 6. Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Italy. 7. Department of Ophthalmology and Otolaryngology, University of Bari, Italy. 8. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy. 9. Research Centre of Systemic Autoinflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. cantariniluca@hotmail.com.
Abstract
OBJECTIVES: To assess the efficacy of monoclonal anti-tumour necrosis factor (TNF)-α agents in patients with anterior uveitis (AU) in terms of decrease of recurrences, variation of visual acuity and steroid sparing effect and to identify any demographic, clinical or therapeutic variables associated with a sustained response to monoclonal TNF-α inhibitors. METHODS: Data from patients suffering from AU treated with adalimumab, infliximab, golimumab or certolizumab pegol were retrospectively collected and statistically analysed. RESULTS: Sixty-nine patients (22 males, 47 females), corresponding to 101 eyes, were enrolled. The mean follow-up period was 29.25±23.51 months. The rate of ocular flares decreased from 42.03 events/100 patients/year recorded during the 12 months preceding the start of TNF-α inhibitors to 2.9 flares/100 patients/year after the start of treatment (p<0.0001). The overall decrease in ocular flares was 93.1%. No statistically significant changes were identified in the best corrected visual acuity during the follow-up period (p>0.99). The number of patients treated with corticosteroids at baseline was significantly higher compared with that referred to the 12-month evaluation (p<0.001) and to the last follow-up visit (p=0.006). Concomitant treatment with conventional disease-modifying anti-rheumatic drugs (cDMARDs) represented the sole clinical, demographic or therapeutic variable associated with long-term treatment duration (p=0.045, R2=0.87). CONCLUSIONS: Monoclonal TNF-α inhibitors induce a remarkable decrease in the recurrence of AU during a long-term follow-up period and lead to a significant steroid sparing effect along with stabilisation of visual acuity. Concomitant treatment with cDMARDs represented the sole variable associated with treatment duration in the long-term.
OBJECTIVES: To assess the efficacy of monoclonal anti-tumour necrosis factor (TNF)-α agents in patients with anterior uveitis (AU) in terms of decrease of recurrences, variation of visual acuity and steroid sparing effect and to identify any demographic, clinical or therapeutic variables associated with a sustained response to monoclonal TNF-α inhibitors. METHODS: Data from patients suffering from AU treated with adalimumab, infliximab, golimumab or certolizumab pegol were retrospectively collected and statistically analysed. RESULTS: Sixty-nine patients (22 males, 47 females), corresponding to 101 eyes, were enrolled. The mean follow-up period was 29.25±23.51 months. The rate of ocular flares decreased from 42.03 events/100 patients/year recorded during the 12 months preceding the start of TNF-α inhibitors to 2.9 flares/100 patients/year after the start of treatment (p<0.0001). The overall decrease in ocular flares was 93.1%. No statistically significant changes were identified in the best corrected visual acuity during the follow-up period (p>0.99). The number of patients treated with corticosteroids at baseline was significantly higher compared with that referred to the 12-month evaluation (p<0.001) and to the last follow-up visit (p=0.006). Concomitant treatment with conventional disease-modifying anti-rheumatic drugs (cDMARDs) represented the sole clinical, demographic or therapeutic variable associated with long-term treatment duration (p=0.045, R2=0.87). CONCLUSIONS: Monoclonal TNF-α inhibitors induce a remarkable decrease in the recurrence of AU during a long-term follow-up period and lead to a significant steroid sparing effect along with stabilisation of visual acuity. Concomitant treatment with cDMARDs represented the sole variable associated with treatment duration in the long-term.
Authors: Claudia Fabiani; Antonio Vitale; Giacomo Emmi; Arianna Sgheri; Giuseppe Lopalco; Jurgen Sota; Silvana Guerriero; Florenzo Iannone; Bruno Frediani; Lorenzo Vannozzi; Maria Teresa Bianco; Valtere Giovannini; Gian Marco Tosi; Luca Cantarini Journal: Front Pharmacol Date: 2019-12-09 Impact factor: 5.810
Authors: Irene E van der Horst-Bruinsma; Philip C Robinson; Ennio G Favalli; Frank D Verbraak; Mindy Kim; Thomas Kumke; Lars Bauer; Bengt Hoepken; Atul Deodhar Journal: Rheumatol Ther Date: 2022-09-30
Authors: Irene van der Horst-Bruinsma; Rianne van Bentum; Frank D Verbraak; Thomas Rath; James T Rosenbaum; Maria Misterska-Skora; Bengt Hoepken; Oscar Irvin-Sellers; Brenda VanLunen; Lars Bauer; Martin Rudwaleit Journal: RMD Open Date: 2020-04