Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
Clin Exp Rheumatol. 2020 Nov-Dec;38(6):1138-1144. Epub 2020 Apr 17.
To evaluate the efficacy of tumour necrosis factor (TNF)-α inhibitors in refractory non-infectious scleritis.
We carried out a retrospective study assessing the efficacy of TNF-α inhibitors in the treatment of scleritis, scleritis relapses, glucocorticoid (GC)-sparing effect, impact on best-corrected visual acuity (BCVA) and safety profile.
Nineteen patients (28 eyes) were eligible for analysis. Scleritis inflammatory grading significantly improved from baseline to the last follow-up (median ± IQR 2±4 and 0±0 respectively, p=0.0006). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.001). Mean GC dosage decreased from baseline (19.00±13.56 mg) to the last follow-up (7.59±5.56 mg) (p=0.003). No significant differences regarding BCVA were observed. Two AEs were recorded (1 severe urticaria and 1 case of pneumonia and paradoxical psoriasis).
TNF-α inhibitors are effective in the treatment of scleritis while allowing a GC-sparing effect and preserving BCVA.
评估肿瘤坏死因子（TNF）-α抑制剂在难治性非感染性巩膜炎中的疗效。
我们进行了一项回顾性研究，评估 TNF-α抑制剂治疗巩膜炎、巩膜炎复发、糖皮质激素（GC）节省效应、对最佳矫正视力（BCVA）的影响和安全性。
19 名患者（28 只眼）符合纳入标准。巩膜炎炎症分级从基线到最后一次随访显著改善（中位数±IQR 2±4 和 0±0，分别为 p=0.0006）。生物治疗前 12 个月和后 12 个月的巩膜炎复发明显减少（p=0.001）。GC 剂量从基线（19.00±13.56mg）降至最后一次随访（7.59±5.56mg）（p=0.003）。BCVA 无显著差异。记录到 2 例不良反应（1 例严重荨麻疹和 1 例肺炎和矛盾性银屑病）。
TNF-α抑制剂在治疗巩膜炎方面有效，同时具有 GC 节省效应并保持 BCVA。
