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S.G. Baarsma, R.W. Kuijpers, P.M. van Hagen; Anti-TNF Therapy for Serious Sight-threatening Uveitis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2399.
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Purpose: To evaluate the clinical effect of anti-TNF therapy in serious sight-threatening uveitis resistant to conventional immunosuppressive treatment. The cytokine TNF-alpha is supposed to be important in the pathogenesis of uveïtis because of the high levels in serum and aqueous humor of uveitis patients and patients with Behcet's disease (BD). Anti-TNF treatment has been successful in patients with rheumatoid arthritis and Crohn’s disease Preliminary reports have shown succesfull treatment of BD and uveitis. Methods: Anti-TNF therapy (Infliximab 3-5 mg/kg body weight intravenously or etanercept 2 times 25 mg s.c. weekly) was administered to 15 patients with refractary uveitis (and extra-ocular disease). All of these patients were unsuccessfully treated with other immunosuppressive drugs like; corticosteroids, cyclosporine, methotrexate or interferon-alpha. The majority of the patients (9) had Behcet’s disease. The other patients had sarcoidosis (1), idiopathic uveïtis (2), birdshot retinochoriodopathy (1), Wegener’s granulomatosis (1) or Erdheim Chester (1). Results: Anti-TNF therapy lead to effective suppression of the ocular inflammation and clinical improvement in most patients, especially in the patients with BD. The therapy was well tolerated by most patients; only in one patient the treatment had to be discontinued due to a rash. Conclusions: Anti-TNF therapy is a promising therapy in the treatment of severe sight-threatening uveitis, especially in patients with Behcet’s disease.
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