Regular articleAnti–tumor necrosis factor-alpha therapy with infliximab as an alternative to corticosteroids in the treatment of human leukocyte antigen b27–associated acute anterior uveitis
Section snippets
Materials and methods
This study observed only acute HLA B27–positive uveitis. The clinical trial protocol and informed consent form followed Austrian national guidelines and were approved by the institutional Ethics and Research Committee; written, informed consent was obtained from all patients. The study conformed to the tenets of the Declaration of Helsinki, as revised in 1989. Disease activity was graded in accordance with the International Uveitis Study Group.17 Anterior chamber cells, as a validated indicator
Results
Seven patients received a single infusion of 10 mg/kg of infliximab. Because of a flare-up, one patient received a second infusion 3 weeks after the first. Table 1 outlines patient data on enrollment. The median age of the patients was 40 ± 13 years. The median follow-up was 17 ± 0.8 months. All but one patient had a history of at least one episode of uveitis. The current flare-up involved only one eye in all patients, and only one of them (patient 5) had received prior treatment with hourly
Discussion
We present the results of IV treatment of seven patients with HLA B27–positive anterior uveitis with infliximab at a dosage of 10 mg/kg. This dosage was used because it was proven to be highly effective in prior studies of patients with rheumatoid arthritis.13 Infliximab was very efficient in suppressing intraocular inflammation; clinical symptoms improved significantly, and anterior chamber cells decreased rapidly. Only one patient with positive CRP levels as a systemic sign of inflammation
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2014, Best Practice and Research: Clinical RheumatologyCitation Excerpt :In addition, a retrospective study in RA patients [101] reported 43 new cases with uveitis during etanercept treatment (400.000 patient years), 14 cases during infliximab (700.000 PY) and two during adalimumab (160.000 PY). An analysis of four placebo-controlled studies and three open-label studies with TNF inhibitors in AS showed a frequency of flares of anterior uveitis in the placebo group of 15.6/100 PY, compared with 7.9/100 PY in the etanercept group and 3.4/100 PY in the infliximab-treated patients [88]. The attacks of uveitis during these studies were reported by the patients and no follow-up studies or ophthalmologic controls were performed.