Fuchs, Dominic; Bograd, Alexandra; Pfister, Isabel B; Bächtiger, Josephin; Spindler, Jan; Hoogewoud, Florence; Gugleta, Konstantin; Böni, Christian; Guex-Crosier, Yan; Garweg, Justus G; Tappeiner, Christoph (2023). Efficacy of TNF-Alpha Inhibitors to Control Inflammation and Prevent Secondary Complications in Non-Infectious Uveitis: A Real-Life Experience from Switzerland. (In Press). Ocular immunology and inflammation, pp. 1-6. Taylor & Francis 10.1080/09273948.2023.2263095
Full text not available from this repository. (Request a copy)PURPOSE
To evaluate the efficacy of systemic tumor necrosis factor-alpha inhibitors (TNFi) in the treatment of non-infectious uveitis (NIU).
METHODS
This Swiss multicenter retrospective cohort study included patients with NIU requiring TNFi during the period from 2001 to 2018. Risk factors for the occurrence of new complications were identified using Cox regression analysis and hazard ratios (HR).
RESULTS
Seventy-one patients (126 eyes; mean age 40.6 ± 14.4 years, mean duration of uveitis 46.0 ± 61.8 months) were followed for 40.2 ± 17.3 months after addition of TNFi. Under TNFi, visual acuity improved from 0.2 ± 0.3 to 0.1 ± 0.3 logMAR (p < 0.001). The portion of patients under systemic corticosteroids decreased from 81.7% to 25.4% (p < 0.001), while that for conventional synthetic disease-modifying anti-rheumatic drugs insignificantly decreased from 63.4% to 50.7% (p > 0.05). In 80.2% of eyes, complications were present at baseline with epiretinal gliosis (39.7%), cataract (41.3%) and macular edema (ME; 27.8%) being the most common. New complications under TNFi were encountered in 49.2% of eyes, also including recurrence (5 eyes) or new onset of ME (14 eyes). The need for switching of TNFi was associated with further complications (HR 3.78, p = 0.012).
CONCLUSION
Although the efficacy and tolerability of TNFi in a real-life setting are favorable, treatment is often initiated late, i.e., after many eyes have already developed complications. Even with TNFi, new complications, particularly ME, cannot be completely avoided. Further research is needed to assess the impact of earlier initiation of TNFi therapy.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology |
UniBE Contributor: |
Bograd, Alexandra Emma Olga, Garweg, Justus, Tappeiner, Christoph |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1744-5078 |
Publisher: |
Taylor & Francis |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
09 Oct 2023 12:57 |
Last Modified: |
09 Oct 2023 12:57 |
Publisher DOI: |
10.1080/09273948.2023.2263095 |
PubMed ID: |
37797183 |
Uncontrolled Keywords: |
Complications TNF alpha inhibitors efficacy non-infectious uveitis real-life experience |
URI: |
https://boris.unibe.ch/id/eprint/186939 |
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