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Noriko Oishi, Satoko Yui, Naka Shiratori, Junko Hori; A retrospective study for scleritis therapy with immunosupressant and biological agents. Invest. Ophthalmol. Vis. Sci. 2018;59(9):425.
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To analyze the details of treatment, treatment outcomes and associated-systemic diseases in the scleritis patients who have received immunosuppressant and biological agents at Ocular Inflammation Service of the Nippon Medical School Hospital (NMSH), Ophthalmology.
The data used were from clinical records of 227 patients with scleritis who presented between April 2004 and August 2017 to Ocular Inflammation Service of the NMSH, Ophthalmology. They were analyzed retrospectively.
Patients who required immunosapressant and biological agents were 24 patients (10%) out of 227 patients with scleritis. Among these 24 patients, 14 had diffuse anterior scleritis, 4 had nodular scleritis, 4 had necrotizing anterior scleritis and 2 had posterior scleritis. All of these 24 patients had been treated with oral predonisone before. Sixteen out of 24 patients showed insufficient responses to steroid, and resulted in persistence or relapsing scleritis. Four out of 24 patients could not continue to receive predonisone due to its side effects. On the other hand, 10 patients achieved clinical remission after treatment with methotrexate (MTX), 9 patients with cyclosporine (CsA), 1 patient with mycophenolate mofetil (MMF), 2 patients with cyclophosphamade (CYC), 4 patients with infliximab (IFX), 2 patients with tocilizumab (TCZ), and 4 patients with adalimumab (ADA). Nine out of the 24 patients were treated with two or more agents. Immunosupressant agents were administered in 13 (42%) cases and biologilcal agents were administered in 3 (21%) cases by an ophthalmologist due to high degree of scleral inflammation. Associated-systemic diseases were found in 16 out of 24 patients, including 9 patients with rheumatologic disease, 4 patients with ANCA-associated vasculitis, 2 patients with SAPHO syndrome and 1 patient with relapsing polychondritis. ALL of 24 patients succeeded in steroid-sparing after treatment with immunosuppressant or biological agents, and 10 out of 24 patients were eventually led to steroid-free.
Immunosupressant and biological agents are effective treatment for scleritis.
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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