EVALUATION OF TUMOR NECROSIS FACTOR INHIBITOR THERAPY IN SUSAC SYNDROME
| Autor: | Laure Caspers, Francois Willermain, Jean-François Fils, Isabelle Nubourgh, Joke H. de Boer, Jeannette Ossewaarde-van Norel, Prochore Kamgang Semeu, Gérald Glibert, Tom Buelens, Laurence Postelmans |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Susac Syndrome Adolescent Fundus Oculi medicine.drug_class medicine.medical_treatment Gastroenterology Retina Young Adult 03 medical and health sciences 0302 clinical medicine Prednisone Internal medicine Adalimumab medicine Humans Fluorescein Angiography Adverse effect Glucocorticoids Retrospective Studies Dose-Response Relationship Drug Tumor Necrosis Factor-alpha business.industry Retrospective cohort study General Medicine Infliximab TNF inhibitor Ophthalmology Treatment Outcome Antirheumatic Agents 030221 ophthalmology & optometry Corticosteroid Drug Therapy Combination Female business Tomography Optical Coherence 030217 neurology & neurosurgery Follow-Up Studies medicine.drug |
| Zdroj: | Retina. 40:581-590 |
| ISSN: | 0275-004X |
| DOI: | 10.1097/iae.0000000000002466 |
| Popis: | Purpose To evaluate the effect of tumor necrosis factor (TNF) inhibitor therapy on ocular relapses in patients with Susac syndrome. Methods Multicenter retrospective cohort study of patients diagnosed with Susac syndrome according to classical clinical criteria. We evaluated the disease activity before and after introduction of anti-TNF therapy and its value as a steroid-sparing agent. Results Five patients were included. All were initially treated with a combination of corticosteroids and classical immunosuppressive drugs. Infliximab was started in three patients, and adalimumab was started in two patients. Patients had on average 5 ocular relapses during a mean follow-up time of 2.59 years before introducing a TNF inhibitor, corresponding with on average 1.93 relapses per year. After the introduction of an anti-TNF agent, this number was reduced by factor 5.51 to an average of 0.35 relapses per year for a mean follow-up of 2.86 years (P = 0.10). Before anti-TNF introduction ocular relapses occurred at a mean daily dose of 34 mg of prednisone, whereas with anti-TNF treatment, corticosteroid administration could be completely stopped in four patients with one patient still needing 5 mg daily (P = 0.10). Infliximab and adalimumab generally were well tolerated, and no serious adverse events were reported. Conclusion Although not statistically significant, our results suggest that anti-TNF therapy can be a valuable option for the treatment of ocular Susac syndrome and may especially be considered in those patients unresponsive to more conventional immunosuppressive treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|