title: Biologic therapy for refractory scleritis: a new treatment perspective.
abstract: Scleritis is an umbrella term for a heterogeneous group of ocular diseases that can be associated with autoimmune or systemic disorders. The purpose of this article was to review the literature regarding the use of biologic drugs to treat refractory scleritis. A search of the MEDLINE, Embase, and LILACS electronic databases was conducted, and the reference lists of published articles were hand-searched. No language filters were used. This search strategy yielded no randomized trials of the use of biologic therapies to treat scleritis; only case reports and retrospective studies were retrieved. These studies suggest that monoclonal antibodies (infliximab and adalimumab) are superior to the soluble TNF receptor fusion protein etanercept for the treatment of scleritis in patients that do not respond to corticosteroids and/or to immunosuppressive treatment. Rituximab seems to be the best option for scleritis associated with vasculitis.
authors: Evidence-Based Health Department, Universidade Federal de São Paulo (UNIFESP), Rua Barão do Triunfo, 156/232, São Paulo, SP, 04602-000, Brazil. fidelixtania@gmail.com.
authors: Tania Sales de Alencar
authors: TS
authors: de Fidelix
authors: Ophthalmology Department, UNIFESP, São Paulo, SP, Brazil.
authors: Luis Antonio
authors: LA
authors: Vieira
authors: Ophthalmology Department, UNIFESP, São Paulo, SP, Brazil.
authors: Denise
authors: D
authors: de Freitas
authors: Evidence-Based Health Department, Universidade Federal de São Paulo (UNIFESP), Rua Barão do Triunfo, 156/232, São Paulo, SP, 04602-000, Brazil.
authors: Virginia Fernandes Moça
authors: VF
authors: Trevisani
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001691:Biological Therapy / Q000379:methods*; D000068582:Certolizumab Pegol; D000068800:Etanercept / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab / Q000627:therapeutic use; D015423:Scleritis / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D000068582:Certolizumab Pegol
keywords: Adalimumab; Certolizumab; Etanercept; Infliximab; Rituximab