July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Tumor necrosis factor inhibitors improve inflammatory control in eyes with refractory non-infectious uveitis.
Author Affiliations & Notes
  • Ahmed Al-Janabi
    University College London (UCL) Institute of Ophthalmology, LONDON, United Kingdom
    Moorfields Eye Hospital, London, United Kingdom
  • Amgad El Nokrashy
    Mansoura Ophthalmic Centre, Mansoura university, Mansoura, Egypt
    Moorfields Eye Hospital, London, United Kingdom
  • Lazha Sharief
    University College London (UCL) Institute of Ophthalmology, LONDON, United Kingdom
    Moorfields Eye Hospital, London, United Kingdom
  • Susan Lightman
    University College London (UCL) Institute of Ophthalmology, LONDON, United Kingdom
    Moorfields Eye Hospital, London, United Kingdom
  • Oren Tomkins-Netzer
    University College London (UCL) Institute of Ophthalmology, LONDON, United Kingdom
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Ahmed Al-Janabi, None; Amgad El Nokrashy, None; Lazha Sharief, None; Susan Lightman, None; Oren Tomkins-Netzer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 407. doi:https://doi.org/
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      Ahmed Al-Janabi, Amgad El Nokrashy, Lazha Sharief, Susan Lightman, Oren Tomkins-Netzer; Tumor necrosis factor inhibitors improve inflammatory control in eyes with refractory non-infectious uveitis.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):407. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There has been a recent rise in the use of biologic agents and specifically tumor necrosis factor α (TNFα) inhibitors for eyes with uveitis that are refractory to systemic corticosteroids and other, second-line immunosuppressive agents. The aim of this study was to determine the immunosuppressive effect of TNFα inhibitors on the inflammatory activity and visual function in refractory eyes with non-infectious intermediate, posterior or panuveitis (NIIPPU).

Methods :
This is a cross sectional study of patients diagnosed with NIIPPU and active intra-ocular inflammation. Patients were included if they had active NIIPPU while under treatment with systemic corticosteroids and an additional second-line immunosuppressive agent. Following the initiation of treatment with an TNFα inhibitor agent (baseline) information was gathered regarding disease activity, ocular complications and visual functional.

Results :
129 eyes of 66 patients (25 female) were included in this study. Twenty eight patients (55 eyes, 42.6%) received adalimumab, 36 patients (70 eyes, 54.3%) received infliximab and 2 patients (4 eyes, 3.1%) received etanercept. Average patient follow-up was 7.3±0.4 years following treatment with TNFα inhibitors. At baseline, best corrected visual acuity was 0.57±0.07 LogMAR and remained stable throughout follow-up (p=0.89), while the percentage of patients with severe vision loss remained stable at 27.3%. Following baseline patients were able to significantly reduce their dose of systemic prednisolone from an average of 18.4±1.5mg to 9.8±1mg per day at 3 months (p=0.02), thereafter remaining stable. Following baseline eyes were significantly less likely to have flares than before treatment (2.1±0.6 vs. 0.7±0.1 flares per year, p=0.02) and more likely to remain quiescent (32% vs. 6.2%, p<0.0001).

Conclusions :
Treatment with TNFα inhibitors results in improved long-term disease control while maintaining visual function.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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