June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Experience with High Dose Infliximab and Biosimilar Infliximab-dyyb for Non-infectious Uveitis
Author Affiliations & Notes
  • Katherine Joltikov
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Monique Munro
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Pooja Bhat
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Ann-Marie Lobo
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Katherine Joltikov None; Monique Munro None; Pooja Bhat None; Ann-Marie Lobo None
  • Footnotes
    Support  P30 EY001792, unrestricted departmental funding from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3195 – A0421. doi:
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      Katherine Joltikov, Monique Munro, Pooja Bhat, Ann-Marie Lobo; Experience with High Dose Infliximab and Biosimilar Infliximab-dyyb for Non-infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3195 – A0421.

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

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Abstract

Purpose : Infliximab and biosimilar infliximab-dyyb are widely used for steroid sparing treatment of non-infectious uveitis. The purpose of this study is to report on the safety and efficacy of high-dose infliximab (INX) and biosimilar infliximab-dyyb (INXB), and immunogenicity of INXB, in the treatment of non-infectious uveitis.

Methods : A retrospective review of all patients with non-infectious uveitis treated with INX and/or INXB from 2016 to 2021 was conducted. Data collected included patient demographics, best corrected visual acuity (BCVA), INX/INXB dosage information and any adverse effects, additional immunosuppression medication, and clinical evidence of uveitis flare or quiescence. An active flare was defined as a two-step increase in the level of inflammation, and quiescence was defined as <1/2+ cell in the anterior chamber, no vitreous haze and no active posterior segment findings. Positive clinical immunogenicity was defined as an increased number of flares and/or decreased period of quiescence after starting INXB.

Results : A total of 35 patients met the inclusion criteria. The mean age was 42.6±13.6 years and 24 (69%) were female. Sixteen patients (46%) were African American, 13(37%) were Caucasian, and 5(14%) were Hispanic. Intermediate uveitis (8/35) was the most common diagnosis, followed by scleritis (7/35), anterior uveitis (7/35), and pan-uveitis (5/35). Seven patients had retinal vasculitis and 11 had a co-existing rheumatologic diagnosis (including 4 Bechet’s, 3 sarcoidosis, and 2 rheumatoid arthritis). Eight patients received INXB; 4 patients were switched from INX to INXB due to insurance coverage, and 4 were started de-novo. The highest dosages of INX and INXB were 10mg/kg and 12.5mg/kg every 4 weeks, respectively. There were no significant adverse effects associated with high dose INX or INXB, and no significant uveitis flares in the 4 patients that were switched from INX to INXB.

Conclusions : The findings of this retrospective study provide insight into the safety and effectiveness of high-dose INX and INXB in the treatment of non-infectious uveitis. Biosimilar infliximab-dyyb was well-tolerated, safe, and appeared to be of similar clinical effectiveness to originator infliximab, and thus may be a potential cost-effective alternative.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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