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H. N. Sen, R. Buggage, K. Hammel, G. Levy-Clarke, R. Nussenblatt; Infliximab for the Treatment of Scleritis and Chronic Recalcitrant Uveitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4724.
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To evaluate the effectiveness of infliximab in patients with chronic recalcitrant uveitis and scleritis.
Clinical charts of 10 patients with chronic uveitis, treated with infliximab infusions at NEI under a compassionate protocol between 2003 and 2006 and the results of prospective pilot study of Infliximab for active non-necrotizing scleritis in 5 patients (protocol# 04-EI-0065; 2004-2007) were reviewed. Results are reported using SUN criteria.
In the uveitis group recurrence rate and concomitant immunosuppressive use decreased with infliximab infusions. In the scleritis group, with respect to the primary endpoint, all five participants achieved control of their active scleritis within 14 weeks of initiating infliximab therapy. One patient developed new onset intraocular inflammation after 14 weeks that did not respond to reinduction and was terminated from the study. Side effects attributable to infliximab in uveitis group included a skin abscess, oral candidiasis and non-TB mycobacterial pneumonia, and in the scleritis group ear infection with transient decreased hearing, UTI, lower RTI and facial rash in one patient and UTI, diarrhea, upper RTI in another all of which resolved with appropriate treatment.
Infliximab may be considered as a viable option in patients with severe chronic recalcitrant uveitis who have developed intolerance to conventional immunosuppressives and in patients with active scleritis; however patients should be monitored closely for potentially serious side effects.
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