June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Efficacy and tolerability of subcutaneous repository corticotropin injection in ocular inflammation
Author Affiliations & Notes
  • Negin Yavari
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Hashem Ghoraba
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Chris Or
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Irmak Karaca
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Xun Lyu
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Anthony Le
    University of Missouri Kansas City, Kansas City, Missouri, United States
  • Hassan Khojasteh
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Amir Akhavanrezayat
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Azadeh Mobasserian
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Vahid Bajozoo
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Louis Jison
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • SungWho Park
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
    Ophthalmology, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Muhammad Sohail Halim
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
    Ocular Imaging Research and Reading Center, California, United States
  • Mohamed Ahmed
    Ocular Imaging Research and Reading Center, California, United States
  • Diana V Do
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Quan Dong Nguyen
    Ophthalmology, Stanford University School of Medicine, Palo Alto, California, United States
  • Footnotes
    Commercial Relationships   Negin Yavari None; Hashem Ghoraba None; Chris Or None; Irmak Karaca None; Xun Lyu None; Anthony Le None; Hassan Khojasteh None; Amir Akhavanrezayat None; Azadeh Mobasserian None; Vahid Bajozoo None; Louis Jison None; SungWho Park None; Muhammad Sohail Halim OIRRC, Code E (Employment); Mohamed Ahmed OIRRC, Code E (Employment); Diana Do Allergan, Genentech, Kriya, Regeneron, Code C (Consultant/Contractor), Kodiak, Code I (Personal Financial Interest); Quan Nguyen Belite Bio, Genentech, Kriya, Regeneron, Rezolute, Code C (Consultant/Contractor)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3553. doi:
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      Negin Yavari, Hashem Ghoraba, Chris Or, Irmak Karaca, Xun Lyu, Anthony Le, Hassan Khojasteh, Amir Akhavanrezayat, Azadeh Mobasserian, Vahid Bajozoo, Louis Jison, SungWho Park, Muhammad Sohail Halim, Mohamed Ahmed, Diana V Do, Quan Dong Nguyen; Efficacy and tolerability of subcutaneous repository corticotropin injection in ocular inflammation. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3553.

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

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Abstract

Purpose : Repository corticotropin injection (RCI) has been suggested to exert immunomodulatory and anti-inflammatory effects on ocular inflammatory processes. This retrospective, observational study aimed to evaluate the efficacy and tolerability of subcutaneous RCI in patients with active scleritis and uveitis.

Methods : Medical records of patients who were diagnosed with active scleritis or uveitis and received RCI for more than six months at a tertiary eye center were reviewed. Baseline patient characteristics including age, sex, underlying diseases, clinical findings, treatment details, and adverse events were recorded.

Results : A total of 23 eyes of 17 patients were included. Median age was 43 (27-61) years and 9 (53%) were male. Mean treatment duration was 25.4±15.54 (range, 10-68) months. Indications for RCI were scleritis, panuveitis, retinal vasculitis, chronic/recurrent anterior uveitis, and posterior uveitis in 11 (47.8%), four (17.4%), four (17.4%), three (13%), and one (4.35%) eye, respectively. RCI was given at a dose of 40 to 80 units 1 to 3 times weekly. Mean visual acuity (LogMAR) was 0.15±0.25 at baseline, and 0.14± 0.24 at last visit following RCI therapy. Ocular inflammation was stable in 17 eyes (73.9%) and improved in seven eyes (30.4%); one eye (4.3%) worsened requiring the addition of immunomodulatory therapy (IMT). Side effects included insomnia (23%), hypertension (11.7%), lower extremity edema (11.7%), hyperglycemia (11.7%), weight gain (11.7%), and infection (5.8%). Given the adequate control of inflammation, RCI was successfully discontinued in four patients (23.5%). One patient (5.8%) discontinued RCI due to intolerance (hypertension and hyperglycemia) and five patients (29.4%) due to non-medical reasons. Before initiation of RCI, 13 patients were on oral prednisone daily at 10 mg (3-40), and after six months of RCI therapy, the dose was reduced in seven patients to 3 mg (1-5) and was stopped in five patients. Concomitant IMTs included mycophenolate mofetil (23.5%) and methotrexate (23.5%) along with biologics such as adalimumab (23.5%). IMTs were initiated before RCI in seven patients (41.1%) and after IRC in five patients (29.4%). Dose of IMTs was stable after six months of IRC therapy in eight patients (47%) and decreased in two patients (11.7%).

Conclusions : RCI may be considered a potential therapy with acceptable tolerability for patients with scleritis or uveitis.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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