Efficacy of adalimumab and infliximab in recalcitrant retinal vasculitis inadequately responsive to other immunomodulatory therapies

Claudia Fabiani, Jurgen Sota, Donato Rigante, Antonio Vitale, Giacomo Emmi, Giuseppe Lopalco, Lorenzo Vannozzi, Silvana Guerriero, Alice Bitossi, Ida Orlando, Rossella Franceschini, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Luca Cantarini

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The primary aim of the study was to evaluate the efficacy of tumor necrosis factor (TNF)-α blockers adalimumab (ADA) and infliximab (IFX) in refractory sight-threatening retinal vasculitis (RV) during a 12-month follow-up period. Secondary aims were to evaluate (i) any impact of concomitant conventional disease-modifying anti-rheumatic drugs (cDMARDs) and different lines of biologic therapy; (ii) any difference in terms of efficacy between ADA and IFX; (iii) consequences of biotherapies on the best-corrected visual acuity (BCVA); (iv) corticosteroid-sparing effect; and (vi) ocular complications during anti-TNF-α treatment. Demographic, clinical, and therapeutic data were retrospectively collected from the medical records and statistically analyzed. Forty-eight patients (82 eyes) were recruited, 22 (45.8%) of which received IFX and 26 (54.2%) ADA. The percentages of patients achieving RV remission within 3 and 12 months were 54 and 86%, respectively. A significant decrease in RV detection was identified from baseline to 3-month (p < 0.0001) and 12-month (p < 0.0001) assessments and between 3-month and 12-month visits (p = 0.004). No differences were identified in terms of RV resolution between (i) patients undergoing monotherapy and those co-administered with cDMARDs at 3-month (p = 0.560) and 12-month (p = 0.611) follow-up; (ii) biologic-naïve patients and those already exposed to other biologics at 3-month (p = 0.497) and 12-month (p > 0.99) visits; and (iii) patients treated with ADA and those treated with IFX (p = 0.357). During the study period, a statistically significant corticosteroid-sparing effect was observed (p = 0.0002), while BCVA values did not significantly change (p = 0.950). Anti-TNF-α monoclonal antibodies have proved excellent results in patients with recalcitrant sight-threatening RV.

Original languageEnglish
Pages (from-to)2805-2809
Number of pages5
JournalClinical Rheumatology
Volume37
Issue number10
DOIs
Publication statusPublished - Oct 1 2018

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Retinal Vasculitis
Immunomodulation
Biological Therapy
Tumor Necrosis Factor-alpha
Visual Acuity
Adrenal Cortex Hormones
Antirheumatic Agents
Medical Records
Monoclonal Antibodies
Demography
Adalimumab
Infliximab
Therapeutics

Keywords

  • Adalimumab
  • Behçet’s disease
  • Biologic treatment
  • Infliximab
  • Uveitis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Efficacy of adalimumab and infliximab in recalcitrant retinal vasculitis inadequately responsive to other immunomodulatory therapies. / Fabiani, Claudia; Sota, Jurgen; Rigante, Donato; Vitale, Antonio; Emmi, Giacomo; Lopalco, Giuseppe; Vannozzi, Lorenzo; Guerriero, Silvana; Bitossi, Alice; Orlando, Ida; Franceschini, Rossella; Frediani, Bruno; Galeazzi, Mauro; Iannone, Florenzo; Tosi, Gian Marco; Cantarini, Luca.

In: Clinical Rheumatology, Vol. 37, No. 10, 01.10.2018, p. 2805-2809.

Research output: Contribution to journalArticle

Fabiani, C, Sota, J, Rigante, D, Vitale, A, Emmi, G, Lopalco, G, Vannozzi, L, Guerriero, S, Bitossi, A, Orlando, I, Franceschini, R, Frediani, B, Galeazzi, M, Iannone, F, Tosi, GM & Cantarini, L 2018, 'Efficacy of adalimumab and infliximab in recalcitrant retinal vasculitis inadequately responsive to other immunomodulatory therapies', Clinical Rheumatology, vol. 37, no. 10, pp. 2805-2809. https://doi.org/10.1007/s10067-018-4133-z
Fabiani, Claudia ; Sota, Jurgen ; Rigante, Donato ; Vitale, Antonio ; Emmi, Giacomo ; Lopalco, Giuseppe ; Vannozzi, Lorenzo ; Guerriero, Silvana ; Bitossi, Alice ; Orlando, Ida ; Franceschini, Rossella ; Frediani, Bruno ; Galeazzi, Mauro ; Iannone, Florenzo ; Tosi, Gian Marco ; Cantarini, Luca. / Efficacy of adalimumab and infliximab in recalcitrant retinal vasculitis inadequately responsive to other immunomodulatory therapies. In: Clinical Rheumatology. 2018 ; Vol. 37, No. 10. pp. 2805-2809.
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