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Y El-Shabrawi, J Hermann; Selective Anti-tnfa Therapy With Infliximab In The Treatment Of Hla B27 Associated Uveitis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4275.
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Purpose: The most common acute anterior uveitis is HLAB27 associated. In most instances an adequate response to local corticosteroids is achieved, approximately twenty five percent of patients present with recurrent flare-ups of their iridocyclitis, despite the use of a combined corticosteroid and an immune suppressive therapy. The ongoing inflammation may result in irreversible adverse events like glaucoma, cataracts, chronic cystoid macular edema or epiretinal membranes. The purpose of this case series was to evaluate the efficacy of infliximab, a chimeric human-mouse anti-TNFa monoclonal antibody, that has effectively been used in other HLA B27 associated conditions e.g. seronegative spondylathropathies, in patients with acute or chronic non-responsive HLA B27 associated uveitis. Methods: Seven consecutive patients with and acute anterior HLA b27 associated patients and three patients with chronic, non-responsive anterior uveitis were treated with infusions of infliximab (5 mg/kg). All patients treated for their acute disease and one patient with a chronic uveitis received only one single does, the remaining two chronic uveitis patients received an infusion at 0, 2, and 6 weeks. In cases of an acute disease, inflixmab was used as sole antiinflammatory drug, in patients with a chronic uveitis, at the time the infliximab infusion was started, the systemic and/or local therapy were reduced or stopped. Results: Six out of seven patients with an acute disease went into remission, one patients needed additional low dose steroid drops. All three patients with a chronic disease went into remission. Conclusion: In patients with an acute or chronic HLA-B27 anterior uveitis infusions of infliximab provided a fast and significant improvement.
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