Long-term treatment with rituximab in severe juvenile idiopathic arthritis-associated uveitis

Elisabetta Miserocchi, Giulio Modorati, Luigi Berchicci, Irene Pontikaki, Pier Luigi Meroni, Valeria Gerloni

Research output: Contribution to journalArticle

Abstract

BACKGROUND/AIMS: To evaluate retrospectively the long-term efficacy of rituximab in patients with severe juvenile idiopathic arthritis (JIA)-associated uveitis.

METHODS: Eight patients (15 eyes) with severe and longstanding JIA uveitis, who had an inadequate response in controlling uveitis to one or more biologic agents including tumour necrosis factor blockers and abatacept, received rituximab therapy. Rituximab was given at a dose of 1000 mg per infusion on days 1 and 15 and then every 6 months. Clinical responses to treatment, including decrease in uveitis activity, visual acuity changes, reduction of concomitant local and systemic corticosteroid and/or immunosuppressants, and occurrence of adverse events, were assessed.

RESULTS: Eight patients with a mean±SD age of 22.8±5.5 years were treated. The mean ocular disease duration was 17.7 years; the mean±SD follow-up time on rituximab was 44.75±4.9 months; and the mean number of rituximab infusions received was 8.75 (range 6-12). All patients achieved complete control of uveitis, but in two patients rituximab was discontinued due to inefficacy in treating arthritis. The decrease in uveitis activity was evident 4-5 months after the first infusion. Systemic corticosteroids and immunosuppressants used in association with rituximab were discontinued in five patients at the end of follow-up. None of the patients experienced visual worsening during the follow-up. No drug-related complications were encountered.

CONCLUSIONS: Rituximab may be a promising effective treatment option for refractory uveitis associated with JIA leading to long-term quiescence of uveitis, particularly for patients who have not previously responded to other biologic therapies.

Original languageEnglish
Pages (from-to)782-6
Number of pages5
JournalBritish Journal of Ophthalmology
Volume100
Issue number6
DOIs
Publication statusPublished - Jun 2016

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Juvenile Arthritis
Uveitis
Therapeutics
Immunosuppressive Agents
Adrenal Cortex Hormones
Biological Therapy
Eye Diseases
Rituximab
Biological Factors
Visual Acuity
Arthritis
Tumor Necrosis Factor-alpha
Pharmaceutical Preparations

Keywords

  • Journal Article

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Long-term treatment with rituximab in severe juvenile idiopathic arthritis-associated uveitis. / Miserocchi, Elisabetta; Modorati, Giulio; Berchicci, Luigi; Pontikaki, Irene; Meroni, Pier Luigi; Gerloni, Valeria.

In: British Journal of Ophthalmology, Vol. 100, No. 6, 06.2016, p. 782-6.

Research output: Contribution to journalArticle

Miserocchi, Elisabetta ; Modorati, Giulio ; Berchicci, Luigi ; Pontikaki, Irene ; Meroni, Pier Luigi ; Gerloni, Valeria. / Long-term treatment with rituximab in severe juvenile idiopathic arthritis-associated uveitis. In: British Journal of Ophthalmology. 2016 ; Vol. 100, No. 6. pp. 782-6.
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AU - Miserocchi, Elisabetta

AU - Modorati, Giulio

AU - Berchicci, Luigi

AU - Pontikaki, Irene

AU - Meroni, Pier Luigi

AU - Gerloni, Valeria

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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N2 - BACKGROUND/AIMS: To evaluate retrospectively the long-term efficacy of rituximab in patients with severe juvenile idiopathic arthritis (JIA)-associated uveitis.METHODS: Eight patients (15 eyes) with severe and longstanding JIA uveitis, who had an inadequate response in controlling uveitis to one or more biologic agents including tumour necrosis factor blockers and abatacept, received rituximab therapy. Rituximab was given at a dose of 1000 mg per infusion on days 1 and 15 and then every 6 months. Clinical responses to treatment, including decrease in uveitis activity, visual acuity changes, reduction of concomitant local and systemic corticosteroid and/or immunosuppressants, and occurrence of adverse events, were assessed.RESULTS: Eight patients with a mean±SD age of 22.8±5.5 years were treated. The mean ocular disease duration was 17.7 years; the mean±SD follow-up time on rituximab was 44.75±4.9 months; and the mean number of rituximab infusions received was 8.75 (range 6-12). All patients achieved complete control of uveitis, but in two patients rituximab was discontinued due to inefficacy in treating arthritis. The decrease in uveitis activity was evident 4-5 months after the first infusion. Systemic corticosteroids and immunosuppressants used in association with rituximab were discontinued in five patients at the end of follow-up. None of the patients experienced visual worsening during the follow-up. No drug-related complications were encountered.CONCLUSIONS: Rituximab may be a promising effective treatment option for refractory uveitis associated with JIA leading to long-term quiescence of uveitis, particularly for patients who have not previously responded to other biologic therapies.

AB - BACKGROUND/AIMS: To evaluate retrospectively the long-term efficacy of rituximab in patients with severe juvenile idiopathic arthritis (JIA)-associated uveitis.METHODS: Eight patients (15 eyes) with severe and longstanding JIA uveitis, who had an inadequate response in controlling uveitis to one or more biologic agents including tumour necrosis factor blockers and abatacept, received rituximab therapy. Rituximab was given at a dose of 1000 mg per infusion on days 1 and 15 and then every 6 months. Clinical responses to treatment, including decrease in uveitis activity, visual acuity changes, reduction of concomitant local and systemic corticosteroid and/or immunosuppressants, and occurrence of adverse events, were assessed.RESULTS: Eight patients with a mean±SD age of 22.8±5.5 years were treated. The mean ocular disease duration was 17.7 years; the mean±SD follow-up time on rituximab was 44.75±4.9 months; and the mean number of rituximab infusions received was 8.75 (range 6-12). All patients achieved complete control of uveitis, but in two patients rituximab was discontinued due to inefficacy in treating arthritis. The decrease in uveitis activity was evident 4-5 months after the first infusion. Systemic corticosteroids and immunosuppressants used in association with rituximab were discontinued in five patients at the end of follow-up. None of the patients experienced visual worsening during the follow-up. No drug-related complications were encountered.CONCLUSIONS: Rituximab may be a promising effective treatment option for refractory uveitis associated with JIA leading to long-term quiescence of uveitis, particularly for patients who have not previously responded to other biologic therapies.

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JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

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