对难治性特发性炎症性视网膜血管渗漏患者在首次使用 TNF-α 抑制剂（阿达木单抗或英夫利昔单抗）治疗失败后的第二次 TNF-α 抑制剂（阿达木单抗或英夫利昔单抗）治疗的反应。
Response to the Second TNF-α Inhibitor (Adalimumab or Infliximab) after Failing the First One in Refractory Idiopathic Inflammatory Retinal Vascular Leakage.
机构信息
Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.
The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA.
出版信息
Ocul Immunol Inflamm. 2022 Jul;30(5):1099-1108. doi: 10.1080/09273948.2020.1869787. Epub 2021 Mar 1.
PURPOSE
To determine the response to the second TNF-α inhibitor (adalimumab and infliximab) after failing the first agent in idiopathic inflammatory retinal vascular leakage.
MATERIALS AND METHODS
This was a retrospective observational case series. Patients with the diagnosis of idiopathic inflammatory retinal vascular leakage who had received both infliximab and adalimumab were included in the study.
RESULTS
Twelve and 15 patients received adalimumab (Group one) and infliximab (Group two) as the first treatment, respectively. The remission rates between Group one (58.3%) and Group two (66.7%) were not statistically significant. ( = .4) As the second agent, adalimumab was more effective in younger patients (27.5 ± 20.6) compared to older patients (48.75 ± 10.2). ( = .03). Moreover, patients with lower vision responded marginally better to infliximab as the second treatment ( = .06).
CONCLUSION
Either TNF-α inhibitor, adalimumab and infliximab, can be employed in the treatment of the patients with idiopathic inflammatory retinal vascular leakage who fail one of these agents.
目的
确定在首例 TNF-α 抑制剂（阿达木单抗和英夫利昔单抗）治疗失败后，对特发性炎症性视网膜血管渗漏患者使用第二种 TNF-α 抑制剂（阿达木单抗和英夫利昔单抗）的反应。
材料与方法
这是一项回顾性观察性病例系列研究。本研究纳入了诊断为特发性炎症性视网膜血管渗漏且接受过英夫利昔单抗和阿达木单抗治疗的患者。
结果
分别有 12 例和 15 例患者接受阿达木单抗（第 1 组）和英夫利昔单抗（第 2 组）作为一线治疗。第 1 组（58.3%）和第 2 组（66.7%）之间的缓解率无统计学意义（=0.4）。（=0.4）作为二线药物，阿达木单抗在较年轻的患者（27.5±20.6）中比年龄较大的患者（48.75±10.2）更有效。（=0.03）。此外，视力较低的患者对英夫利昔单抗作为二线治疗的反应略有改善（=0.06）。
结论
TNF-α 抑制剂阿达木单抗和英夫利昔单抗均可用于治疗对其中一种药物治疗失败的特发性炎症性视网膜血管渗漏患者。
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