Elsevier

Ophthalmology

Volume 113, Issue 12, December 2006, Pages 2317-2323
Ophthalmology

Original Article
Differential Effectiveness of Etanercept and Infliximab in the Treatment of Ocular Inflammation

Presented as a poster at: American Academy of Ophthalmology Annual Meeting, October 2005, Chicago, Illinois.
https://doi.org/10.1016/j.ophtha.2006.04.038Get rights and content

Purpose

Anti–tumor necrosis factor α (anti–TNF-α) agents are being used increasingly in refractory inflammatory eye diseases. We reviewed our patients on etanercept and infliximab to determine whether these medications are equally efficacious in controlling ocular inflammation.

Design

Exploratory retrospective analysis.

Participants

Patients with ocular inflammatory disease on an anti–TNF-α agent (etanercept, infliximab).

Methods

Case records of 22 patients treated with anti–TNF-α therapy were reviewed for demographic information, ocular and systemic diagnosis, duration and dose of anti–TNF-α treatment, concomitant ocular and systemic immunosuppressive medications, and treatment response.

Main Outcome Measures

Uveitis recurrence rate, initial treatment response, treatment response, and medication use at 6 months, 1 year, and last visit.

Results

Patients treated with infliximab had a significant decrease in uveitis recurrences after starting therapy compared with those treated with etanercept (59% vs. 0%, P = 0.004). One year after treatment initiation and at final visit, more infliximab-treated patients had an improvement in their ocular inflammation (100% vs. 33%, P = 0.002, and 94% vs. 0%, P<0.001, respectively) and a decreased requirement for topical prednisolone acetate 1% (94% vs. 33%, P = 0.009, and 89% vs. 29%, P = 0.007, respectively) compared with those treated with etanercept. No significant differences in the use of oral corticosteroids and immunosuppressive agents were noted between the 2 groups at 6 months, 1 year, and final visit.

Conclusions

Infliximab was more effective than etanercept in the treatment of recalcitrant uveitis and decreased the use of topical steroids.

Section snippets

Materials and Methods

A retrospective analysis was performed on the case records of 22 patients treated with anti–TNF-α therapy at the Cleveland Clinic Cole Eye Institute. Anti–TNF-α medications included infliximab and etanercept. Institutional review board/ethics committee approval was obtained for the study. Data recorded included demographic information (age, gender, and race), ocular and systemic diagnoses, duration and dose of anti–TNF-α treatment, concomitant ocular and systemic immunosuppressive medications,

Results

The charts of 22 patients on anti–TNF-α therapy were reviewed. Our cohort included 20 Caucasian individuals and 2 African Americans, whose ages ranged from 11 to 70 years (37±19) (Table 1). Nineteen patients had an underlying systemic disorder. Comparing patients treated with etanercept with patients treated with infliximab (including and excluding those previously on etanercept), the groups were similar with respect to age, gender, and race (Table 2). The location of inflammation differed

Discussion

The use of anti–TNF-α therapy as an adjuvant in the treatment of refractory uveitis has gained popularity in recent years. Several studies have been published recently examining the effectiveness of therapy on ocular inflammatory disease (Table 4). Treatments of HLA-B27–associated anterior uveitis,2 uveitis and scleritis associated with rheumatic articular disease,1 ocular Behçet’s syndrome,3, 4 refractory posterior uveitis,5, 6 sarcoidosis,7 and uveitis associated with juvenile idiopathic

References (16)

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Cited by (0)

Manuscript no. 2005-1190.

The authors received no financial support and have no conflict of interest.

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