Department of Ophthalmology, University of California, San Francisco, California 94143-0412, USA.
Ocul Immunol Inflamm. 2012 Feb;20(1):18-26. doi: 10.3109/09273948.2011.633205.
To describe the corticosteroid-sparing success in controlling chronic uveitis in patients treated with TNFα inhibitors.
Retrospective longitudinal case series of patients started on infliximab (n = 31) or adalimumab (n = 12) for chronic noninfectious uveitis at a tertiary referral center. The main outcome was corticosteroid-sparing success. Secondary outcomes were sustained control of inflammation regardless of corticosteroid-sparing effect, tapering of concurrent nonbiologic therapy, and discontinuation.
Sustained control of inflammation with corticosteroid-sparing success on infliximab and adalimumab, respectively, was achieved in 33.3 and 37.5% at 3 months, 60.7 and 62.5% at 6 months, and 60.9 and 57.1% at 12 months. Median time to this outcome was 98 days for infliximab and 169 days for adalimumab. Six infliximab patients had adverse reactions.
Infliximab and adalimumab improve control of ocular inflammation and are successful corticosteroid-sparing agents. However, time to corticosteroid-sparing control of inflammation may take a few months with either agent, and adverse reactions may limit treatment.
描述 TNFα 抑制剂治疗的患者中，控制慢性葡萄膜炎时皮质类固醇激素节省的成功案例。
在一家三级转诊中心，对接受英夫利昔单抗（n=31）或阿达木单抗（n=12）治疗的慢性非传染性葡萄膜炎患者进行回顾性纵向病例系列研究。主要结局是皮质类固醇激素节省的成功。次要结局是炎症的持续控制，无论皮质类固醇激素节省效果如何，同时减少非生物治疗，以及停药。
分别在 3 个月、6 个月和 12 个月时，英夫利昔单抗和阿达木单抗达到皮质类固醇激素节省成功的炎症持续控制的比例分别为 33.3%和 37.5%、60.7%和 62.5%、60.9%和 57.1%。达到该结果的中位时间分别为英夫利昔单抗的 98 天和阿达木单抗的 169 天。有 6 名英夫利昔单抗患者出现不良反应。
英夫利昔单抗和阿达木单抗可改善眼部炎症的控制，并且是成功的皮质类固醇激素节省药物。然而，使用任何一种药物实现炎症的皮质类固醇激素节省控制可能需要几个月的时间，且不良反应可能限制治疗。
