title: Treatment of chronic, noninfectious, nonnecrotizing scleritis with tumor necrosis factor alpha inhibitors.
abstract: OBJECTIVE
  To evaluate the use of TNF-alpha inhibitors for non-infectious, non-necrotizing scleritis.
  
  
  METHODS
  We conducted a retrospective chart review of patients with non-infectious, non-necrotizing scleritis treated at our institutions from 2002 to 2012.
  
  
  RESULTS
  Seventeen patients (26 eyes) were included. Ten patients were started on infliximab and seven on adalimumab; five patients were treated with both TNF-alpha inhibitors on separate occasions. All patients had an associated autoimmune disease. Control of active inflammation for at least 2 months was achieved in 15 (88%) of 17 patients. Seven out of eight patients successfully tapered concurrent corticosteroid use. Only one patient discontinued TNF-alpha inhibitor use due to an allergic reaction.
  
  
  CONCLUSIONS
  TNF-alpha inhibitors appear to have a role in managing non-infectious, non-necrotizing scleritis refractory to initial therapy, mainly by reducing inflammation and decreasing concurrent CS use.
authors.affiliation: Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School , Newark, New Jersey , USA , and.
authors.forename: Ashwinee
authors.initials: A
authors.lastname: Ragam
authors.forename: Anton M
authors.initials: AM
authors.lastname: Kolomeyer
authors.forename: Christina
authors.initials: C
authors.lastname: Fang
authors.forename: Yinfei
authors.initials: Y
authors.lastname: Xu
authors.forename: David S
authors.initials: DS
authors.lastname: Chu
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015423:Scleritis / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab
keywords: Inflammation, noninfectious scleritis; TNF-alpha inhibitors