Abstract | PURPOSE: DESIGN: Multicenter, retrospective, observational study. PARTICIPANTS: METHODS: Patients received anti-TNF-α agents ( infliximab 5 mg/kg at week 0, 2, 6, and every 4-6 weeks [n = 69] and adalimumab 40 mg/2 weeks [n = 80]) and tocilizumab (8 mg/kg every 4 weeks intravenously [n = 39] and 162 mg/week subcutaneously [n = 16]). MAIN OUTCOME MEASURES: Analysis of complete and partial response rates, relapse rate, low vision (visual acuity in at least 1 eye of ≥ 1 logarithm of the minimum angle of resolution), corticosteroid-sparing effect, and adverse events at 6 months. RESULTS: Two hundred four patients (median age, 40 years [interquartile range, 28-58 years]; 42.2% men) were included. Main causes of uveitis included Behçet's disease (17.2%), birdshot chorioretinopathy (11.3%), and sarcoidosis (7.4%). The overall response rate at 6 months was 46.2% (21.8% of complete response) with anti-TNF-α agents and 58.5% (35.8% of complete response) with tocilizumab. In multivariate analysis, treatment with tocilizumab (odds ratio, 2.10; 95% confidence interval [CI], 1.06-4.06; P = 0.03) was associated independently with complete response of uveitic ME compared with anti-TNF-α agents. Anti-TNF-α agents and tocilizumab did not differ significantly in terms of relapse rate (hazard ratio, 1.00; 95% CI, 0.31-3.18; P = 0.99) or occurrence of low vision (odds ratio, 1.02; 95% CI, 0.51-2.07; P = 0.95) or corticosteroid-sparing effect (P = 0.29). Adverse events were reported in 20.6% of patients, including serious adverse events reported in 10.8% of patients. CONCLUSIONS:
Tocilizumab seems to improve complete response of uveitic ME compared with anti-TNF-α agents.
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Authors | Mathilde Leclercq, Anaïs Andrillon, Georgina Maalouf, Pascal Sève, Philip Bielefeld, Julie Gueudry, Thomas Sené, Thomas Moulinet, Bénédicte Rouvière, Damien Sène, Anne-Claire Desbois, Fanny Domont, Sara Touhami, Carolla El Chamieh, Patrice Cacoub, Bahram Bodaghi, Lucie Biard, David Saadoun |
Journal | Ophthalmology
(Ophthalmology)
Vol. 129
Issue 5
Pg. 520-529
(05 2022)
ISSN: 1549-4713 [Electronic] United States |
PMID | 34793830
(Publication Type: Journal Article, Multicenter Study, Observational Study)
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Copyright | Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Antibodies, Monoclonal, Humanized
- Tumor Necrosis Factor Inhibitors
- Tumor Necrosis Factor-alpha
- tocilizumab
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Topics |
- Adult
- Antibodies, Monoclonal, Humanized
- Female
- Humans
- Macular Edema
(drug therapy, etiology)
- Male
- Middle Aged
- Recurrence
- Retrospective Studies
- Treatment Outcome
- Tumor Necrosis Factor Inhibitors
- Tumor Necrosis Factor-alpha
(therapeutic use)
- Uveitis
(etiology)
- Vision, Low
(complications)
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