Anti-Interleukin-6 Receptor Tocilizumab for Severe Juvenile Idiopathic Arthritis-Associated Uveitis Refractory to Anti-Tumor Necrosis Factor Therapy: A Multicenter Study of Twenty-Five Patients
| Autor: | Berta López-Montesinos, María Carmen González-Vela, José L. Hernández, Montserrat Santos-Gómez, B. Bravo, O. Maíz, Alfredo Adán, Natalia Palmou-Fontana, Javier Loricera, M. Isabel González-Fernández, Vanesa Calvo-Río, Antonio Atanes, R. Demetrio-Pablo, Ricardo Blanco, Inmaculada Calvo, Maria Victoria Hernández, Gisela Díaz-Cordovés, Consuelo Modesto, Miguel A. González-Gay, Marina Mesquida |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
genetic structures Immunology Gastroenterology Etanercept 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Rheumatology Prednisone Internal medicine medicine Adalimumab Immunology and Allergy 030203 arthritis & rheumatology Anakinra business.industry medicine.disease eye diseases Golimumab Infliximab Surgery chemistry 030221 ophthalmology & optometry business Uveitis medicine.drug |
| Zdroj: | Arthritis & Rheumatology. 69:668-675 |
| ISSN: | 2326-5191 |
| DOI: | 10.1002/art.39940 |
| Popis: | Objective To assess the efficacy of tocilizumab (TCZ) for the treatment of juvenile idiopathic arthritis (JIA)–associated uveitis. Methods We conducted a multicenter study of patients with JIA-associated uveitis that was refractory to conventional immunosuppressive drugs and anti–tumor necrosis factor (anti-TNF) agents. Results We assessed 25 patients (21 female; 47 affected eyes) with a mean ± SD age of 18.5 ± 8.3 years. Uveitis was bilateral in 22 patients. Cystoid macular edema was present in 9 patients. Ocular sequelae found at initiation of TCZ included cataracts (n = 13), glaucoma (n = 7), synechiae (n = 10), band keratopathy (n = 12), maculopathy (n = 9), and amblyopia (n = 5). Before TCZ, patients had received corticosteroids, conventional immunosuppressive drugs, and biologic agents (median 2 [range 1–5]), including adalimumab (n = 24), etanercept (n = 8), infliximab (n = 7), abatacept (n = 6), rituximab (n = 2), anakinra (n = 1), and golimumab (n = 1). Patients received 8 mg/kg TCZ intravenously every 4 weeks in most cases. TCZ yielded rapid and maintained improvement in all ocular parameters. After 6 months of therapy, 79.2% of patients showed improvement in anterior chamber cell numbers, and 88.2% showed improvement after 1 year. Central macular thickness measured by optical coherence tomography in patients with cystoid macular edema decreased from a mean ± SD of 401.7 ± 86.8 μm to 259.1 ± 39.5 μm after 6 months of TCZ (P = 0.012). The best-corrected visual acuity increased from 0.56 ± 0.35 to 0.64 ± 0.32 (P |
| Databáze: | OpenAIRE |
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