Different roles of TNF inhibitors in acute anterior uveitis associated with ankylosing spondylitis: state of the art.
The purpose of the present review was to provide a comprehensive picture of the efficacy of the different tumor necrosis factor (TNF)-α inhibiting agents in the treatment of acute anterior uveitis (AAU), the most common extra-articular manifestation of ankylosing spondylitis (AS). AS related, AAU may lead to severe visual impairment, due to frequent flare recurrences, anterior, and posterior segment complications and traditional treatment side effects. Considerably higher levels of tumor necrosis factor (TNF) have been assessed in the aqueous humor and inflamed joints of patients with AS. Anti-TNF drugs have shown efficacy in preventing relapses of rheumatological manifestations of spondyloarthropathies. Several studies have underlined the sustained efficacy of the monoclonal anti-TNF antibodies also in reducing the recurrence of anterior chamber flares in patients with AS-related AAU. On the other hand, retrospective studies and observational reports have indicated lower effectiveness and some paradoxical occurrence of uveitis following treatment with the soluble receptor agent etanercept. Growing evidence suggests that a prophylactic strategy could be advocated in subjects with frequent and recalcitrant attacks of AS-AAU. In this regard, the administration of monoclonal anti-TNF antibodies such as adalimumab (ADA) has been shown to significantly reduce the rate of AAU recurrences. Indeed, during ADA treatment about 90 % of patients have shown to remain completely free of attacks for the entire follow-up period, in most studies. Further studies are needed to confirm the long-term efficacy of TNF inhibitors in AS related AAU and also their role in preventing ocular complications and visual impairment.
Department of Ophthalmology, Humanitas Research Hospital, Rozzano, Milan, Italy. claudia.fabiani@gmail.com.
Claudia
C
Fabiani
Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy.
Antonio
A
Vitale
Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy.
Giuseppe
G
Lopalco
Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy.
Florenzo
F
Iannone
Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy.
Bruno
B
Frediani
Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, University of Siena, Siena, Italy.
Luca
L
Cantarini
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D006801:Humans; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014606:Uveitis, Anterior / Q000150:complications / Q000188:drug therapy*
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha
Ankylosing spondylitis; Anterior uveitis; Biologics; Spondyloarthritis; TNF inhibitors
Case Rep Med. 2014;2014:471319
24991219
Ophthalmology. 1998 Sep;105(9):1646-51
9754172
Ann Rheum Dis. 2011 Jun;70(6):896-904
21540199
Ophthalmology. 2014 Mar;121(3):785-96.e3
24359625
Semin Arthritis Rheum. 2016 Aug;46(1):95-101
27060872
Eye (Lond). 2000 Jun;14 ( Pt 3A):340-3
11026996
Rheumatology (Oxford). 2015 Apr;54(4):633-40
25234663
Arthritis Care Res (Hoboken). 2015 Oct;67(10):1475-80
25832312
Ocul Immunol Inflamm. 1999 Jun;7(2):85-92
10420203
Ann Rheum Dis. 2015 Nov;74(11):1990-5
24928841
Arthritis Rheum. 2005 Aug;52(8):2447-51
16052578
Curr Med Res Opin. 2004;20(2):155-7
15006008
J Rheumatol. 2009 Apr;36(4):801-8
19273449
Rheumatol Int. 2010 Sep;30(11):1437-40
19851772
Ann Rheum Dis. 2015 Jan;74(1):65-73
23999006
Clin Drug Investig. 2015 Jan;35(1):23-9
25388909
Clin Exp Ophthalmol. 2014 May-Jun;42(4):392-5
24024585
Arthritis Rheumatol. 2015 Mar;67(3):668-77
25470228
Clin Exp Rheumatol. 2014 Nov-Dec;32(6):864-8
25288110
Ophthalmic Res. 2001 Sep-Oct;33(5):251-5
11586057
Ann Rheum Dis. 2008 Jul;67(7):955-9
17962239
J Rheumatol. 2014 Aug;41(8):1675-82
25028373
Ocul Immunol Inflamm. 2017 Jun;25(3):405-412
27003323
Ocul Immunol Inflamm. 2013 Apr;21(2):108-14
23252660
Arthritis Care Res (Hoboken). 2016 Jun;68(6):838-44
26815944
Rheumatology (Oxford). 2011 Sep;50(9):1690-9
21672969
Arthritis Rheum. 2005 Jan;52(1):269-74
15641041
Rheumatol Int. 2006 Oct;26(12):1143-6
16957887
J Glaucoma. 2004 Dec;13(6):461-5
15534470
Ophthalmology. 1994 Jul;101(7):1267-74
8035991
Expert Opin Biol Ther. 2014 May;14(5):583-600
24502344
Semin Ophthalmol. 2016 Jul 12;:1-13
27404944
Arthritis Res Ther. 2013;15(5):R113
24020968
Ann Rheum Dis. 2006 Dec;65(12):1631-4
16901960
Arthritis Rheumatol. 2016 Jun;68(6):1522-30
27015607
J Rheumatol. 2014 Sep;41(9):1843-8
25086071
J Rheumatol. 2015 Dec;42(12):2229-37
26472414
Arthritis Res Ther. 2014;16(3):109
25167369
Ocul Immunol Inflamm. 2016;24(2):167-72
25325834
Best Pract Res Clin Rheumatol. 2006 Jun;20(3):401-17
16777573
J Rheumatol. 2003 Jun;30(6):1277-9
12784403
Arthritis Care Res (Hoboken). 2012 Jun;64(6):919-24
22262475
Ocul Immunol Inflamm. 2014 Apr;22(2):90-5
24143896
Jpn J Ophthalmol. 1998 Jul-Aug;42(4):262-8
9749865
Rheumatol Int. 2013 Sep;33(9):2199-213
23686218
Ann Rheum Dis. 2009 May;68(5):696-701
18662932
Surv Ophthalmol. 2005 Jul-Aug;50(4):364-88
15967191
J Neuroimmunol. 2006 Feb;171(1-2):45-56
16288810
Prog Retin Eye Res. 2010 Nov;29(6):610-21
20813201
Ocul Immunol Inflamm. 2015 Apr;23 (2):118-26
24295124
Br J Ophthalmol. 2000 Apr;84(4):413-6
10729301
Ocul Immunol Inflamm. 2005 Sep-Oct;13(5):367-73
16419422
Mediators Inflamm. 2014;2014:717598
24976689
Am J Ophthalmol. 2016 Oct;170:32-40
27470062
Am J Ophthalmol. 1991 Sep 15;112(3):317-21
1882942
Ann Rheum Dis. 2012 May;71(5):700-6
22128084
Arthritis Rheum. 2011 Jun;63(6):1543-51
21630245
Ann Rheum Dis. 2012 Jun;71(6):878-84
22128083
Clin Exp Rheumatol. 2013 Mar-Apr;31(2):320-1
23331715
Clin Exp Rheumatol. 2010 Mar-Apr;28(2):238-45
20483046
Ann Rheum Dis. 2007 Mar;66(3):419-21
16901959
Ann Rheum Dis. 2015 Mar;74(3):e22
25467296
Am J Ophthalmol. 2010 Oct;150(4):534-542.e2
20643395
Curr Med Res Opin. 2014 Dec;30(12):2515-21
25252590
Medicine (Baltimore). 2015 Jul;94(30):e1170
26222847
Case Rep Ophthalmol. 2014 Feb 12;5(1):54-9
24707273
Clin Rheumatol. 2015 Jun;34(6):999-1002
25953065
Clin Rheumatol. 2007 Jun;26(6):953-7
17021671
Clin Rheumatol. 2015 Nov;34(11):1913-20
26070537
Br J Rheumatol. 1983 Nov;22(4 Suppl 2):144-5
6606467
Best Pract Res Clin Rheumatol. 2014 Oct;28(5):747-63
25488782
J Biol Chem. 1998 Aug 21;273(34):22128-35
9705358
J Rheumatol. 2000 Sep;27(9):2198-202
10990234
Chem Immunol Allergy. 2007;92:140-54
17264490