New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy
Objective. To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2020/8294560 |
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| author | Claudia Fabiani Jurgen Sota Maite Sainz-de-la-Maza Laura Pelegrín Giacomo Emmi Giuseppe Lopalco Florenzo Iannone Lorenzo Vannozzi Silvana Guerriero Maria Chiara Gelmi Donato Rigante Gian Marco Tosi José Hernández-Rodríguez Luca Cantarini |
| author_facet | Claudia Fabiani Jurgen Sota Maite Sainz-de-la-Maza Laura Pelegrín Giacomo Emmi Giuseppe Lopalco Florenzo Iannone Lorenzo Vannozzi Silvana Guerriero Maria Chiara Gelmi Donato Rigante Gian Marco Tosi José Hernández-Rodríguez Luca Cantarini |
| author_sort | Claudia Fabiani |
| collection | DOAJ |
| description | Objective. To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile. Results. Fourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (p=0.002) and from baseline to the last follow-up visit (p=0.002). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.007). No differences regarding BCVA were observed (p=0.67). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment. Conclusions. Our results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses. |
| format | Article |
| id | doaj-art-44167951d3a24ea4a70c109601523c35 |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-44167951d3a24ea4a70c109601523c352025-02-03T06:05:18ZengWileyMediators of Inflammation0962-93511466-18612020-01-01202010.1155/2020/82945608294560New Potential Weapons for Refractory Scleritis in the Era of Targeted TherapyClaudia Fabiani0Jurgen Sota1Maite Sainz-de-la-Maza2Laura Pelegrín3Giacomo Emmi4Giuseppe Lopalco5Florenzo Iannone6Lorenzo Vannozzi7Silvana Guerriero8Maria Chiara Gelmi9Donato Rigante10Gian Marco Tosi11José Hernández-Rodríguez12Luca Cantarini13Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, ItalyResearch Center of Systemic Autoinflammatory Diseases and Behçet’s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, ItalyClinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, SpainClinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, SpainDepartment of Experimental and Clinical Medicine, University of Florence, Florence, ItalyRheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, ItalyRheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, ItalyDepartment of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, ItalyDepartment of Ophthalmology and Otolaryngology, University of Bari, Bari, ItalyOphthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, ItalyInstitute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, ItalyOphthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, ItalyVasculitis Research Unit and Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, SpainResearch Center of Systemic Autoinflammatory Diseases and Behçet’s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, ItalyObjective. To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile. Results. Fourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (p=0.002) and from baseline to the last follow-up visit (p=0.002). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.007). No differences regarding BCVA were observed (p=0.67). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment. Conclusions. Our results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.http://dx.doi.org/10.1155/2020/8294560 |
| spellingShingle | Claudia Fabiani Jurgen Sota Maite Sainz-de-la-Maza Laura Pelegrín Giacomo Emmi Giuseppe Lopalco Florenzo Iannone Lorenzo Vannozzi Silvana Guerriero Maria Chiara Gelmi Donato Rigante Gian Marco Tosi José Hernández-Rodríguez Luca Cantarini New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy Mediators of Inflammation |
| title | New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy |
| title_full | New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy |
| title_fullStr | New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy |
| title_full_unstemmed | New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy |
| title_short | New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy |
| title_sort | new potential weapons for refractory scleritis in the era of targeted therapy |
| url | http://dx.doi.org/10.1155/2020/8294560 |
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