Differential effectiveness of etanercept and infliximab in the treatment of ocular inflammation.
OBJECTIVE
Anti-tumor necrosis factor alpha (anti-TNF-alpha) 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.


METHODS
Exploratory retrospective analysis.


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


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


METHODS
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.
Galor
Anat
A
Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Perez
Victor L
VL
Hammel
Jeffrey P
JP
Lowder
Careen Y
CY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012189:Retrospective Studies; D015423:Scleritis / Q000188:drug therapy* / Q000503:physiopathology; D055502:Secondary Prevention; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept