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英夫利昔单抗和托珠单抗治疗非感染性视网膜血管炎的 6 个月疗效。

Six-month outcomes of infliximab and tocilizumab therapy in non-infectious retinal vasculitis.

机构信息

Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.

出版信息

Eye (Lond). 2023 Aug;37(11):2197-2203. doi: 10.1038/s41433-022-02315-9. Epub 2022 Nov 28.

Abstract

PURPOSE

To evaluate the efficacy of infliximab (IFX, 5-10 mg/kg) (Group 1) and tocilizumab (TCZ, 4-8 mg/kg) (Group 2) infusions in non-infectious retinal vasculitis (RV) using Angiographic Scoring for the Uveitis Working Group fluorescein angiography (FA) scoring system.

METHODS

Records of 14 patients (24 eyes) in Group 1 and 8 patients (11 eyes) in Group 2 were retrospectively evaluated to assess visual acuity (VA), anterior chamber cell and flare, vitreous haze, central subfield thickness (CST), and FA scoring at baseline and 6 months of follow-up. The measurements were employed to grade in each group.

RESULTS

In Group 1 and 2, respectively, there was no underlying disease in 9 (60%) and 3 (42.9%) patients. Three (42.9%) patients in Group 2 had juvenile idiopathic arthritis (JIA) as the most common identified cause. Mean improvement in VA (log MAR) and CST were 0.04 ± 0.14 and 40.3 ± 78.5 µm in Group 1; 0.04 ± 0.09 and 47.3 ± 82.3 µm in Group 2, respectively. Mean FA scores were significantly reduced from 12.4 ± 5.2 and 11.6 ± 4.4 at baseline to 6.4 ± 5.0 and 5.8 ± 3.9 at 6-month in Group 1 and 2, respectively. In Group 2, 9 eyes of 6 patients (75%) had the history of IFX use prior to TCZ initiation. There was no significant safety concern requiring treatment discontinuation during the follow-up in either group.

CONCLUSION

IFX and TCZ infusions showed statistically significant improvement of non-infectious RV as shown by ASUWOG FA Scoring System. TCZ, as well as IFX, appeared to be effective treatment options for non-infectious RV.

摘要

目的

使用眼内炎工作小组荧光素眼底血管造影(FA)评分系统的血管造影评分,评估英夫利昔单抗(IFX,5-10mg/kg)(第 1 组)和托珠单抗(TCZ,4-8mg/kg)(第 2 组)输注治疗非感染性视网膜血管炎(RV)的疗效。

方法

回顾性评估了第 1 组的 14 名患者(24 只眼)和第 2 组的 8 名患者(11 只眼)的记录,以评估视力(VA)、前房细胞和渗出物、玻璃体混浊、中央视网膜下厚度(CST)和 FA 评分在基线和 6 个月随访时的情况。采用这些指标对每组进行分级。

结果

第 1 组和第 2 组分别有 9 名(60%)和 3 名(42.9%)患者无基础疾病。第 2 组中有 3 名(42.9%)患者为幼年特发性关节炎(JIA),这是最常见的病因。第 1 组 VA(logMAR)和 CST 的平均改善分别为 0.04±0.14 和 40.3±78.5μm;第 2 组分别为 0.04±0.09 和 47.3±82.3μm。第 1 组和第 2 组 FA 评分的平均基线值分别为 12.4±5.2 和 11.6±4.4,6 个月时分别为 6.4±5.0 和 5.8±3.9。第 2 组中,6 名患者(75%)的 9 只眼在开始使用 TCZ 前曾使用过 IFX。在随访期间,两组均无因安全性问题需要停药的情况。

结论

IFX 和 TCZ 输注均显著改善了非感染性 RV,表现为 ASUWOG FA 评分系统。TCZ 与 IFX 一样,似乎是治疗非感染性 RV 的有效选择。

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