title: Infliximab for the treatment of refractory scleritis.
abstract: BACKGROUND Scleritis is a potentially blinding inflammatory disorder. Standard care consists of systemic corticosteroids and immunosuppresants. The authors describe a series of 10 patients suffering from scleritis treated with the TNF inhibitor infliximab because this scleritis was refractory to standard therapy. METHODS The authors reviewed the medical records of patients with scleritis at the Massachusetts Eye Research and Surgery Institution, treated with infliximab. All cases had non-infectious scleritis refractory to traditional immunomodulatory therapy and received 5 mg/kg of infliximab at 4-8-weekly intervals. The main outcome measures evaluated were clinical response, reduction in concomitant immunomodulatory therapy and adverse effects. Inflammation control and visual acuity were assessed using life-table methods. RESULTS A favourable clinical response to infliximab was seen in 100% of the patients, with six (60%) of them achieving remission and cessation of concomitant immunosuppression. A clinical response to infliximab therapy occurred within 13.24 weeks on average. Based on clinical response, the authors found that repeat monthly infusions were required to maintain remission. One (10%) patient developed a lupus-like reaction necessitating discontinuation of infliximab. CONCLUSION Infliximab may be considered in the treatment of non-infectious scleritis refractory to other treatment.
authors: Massachusetts Eye Research and Surgery Institution, 5 Cambridge Center, Cambridge, MA 02142, USA.
authors: Priyanka
authors: P
authors: Doctor
authors: Amyna
authors: A
authors: Sultan
authors: Sana
authors: S
authors: Syed
authors: William
authors: W
authors: Christen
authors: Pooja
authors: P
authors: Bhat
authors: C Stephen
authors: CS
authors: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015423:Scleritis / Q000188:drug therapy* / Q000503:physiopathology; D017211:Treatment Failure; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab