Case reportTumor necrosis factor α blockade with infliximab for refractory uveitis and scleritis☆
Section snippets
Methods
A retrospective analysis was carried out of the case records of seven patients with scleritis or uveitis who received infliximab (Remicade, Schering-Plough, Welwyn Garden City, UK) from July 2000 to May 2002. Treatment was given on a compassionate basis for either sight-threatening disease or intractable pain after failure of alternative immunosuppression. Institutional review board/ethics committee approval was not required for this study. All patients attended the ocular inflammatory disease
Results
Presenting diagnoses were scleritis (three patients), scleritis with peripheral ulcerative keratitis (one patient), intermediate uveitis (one patient), idiopathic retinal vasculitis with panuveitis (one patient), and chronic juvenile anterior uveitis (one patient). Four patients had an underlying systemic inflammatory disorder, including a perinuclear antineutrophil cytoplasmic antibody positive systemic vasculitis with renal involvement, juvenile idiopathic arthritis, rheumatoid arthritis, and
Discussion
Infliximab, a chimeric monoclonal antibody to TNF-α, is a novel immunomodulatory agent that has shown great promise in a number of autoimmune diseases, in particular rheumatoid arthritis and Crohn's disease and, more recently, psoriasis and systemic vasculitis.6, 7, 8, 11, 12 In view of this, we treated seven patients with noninfectious ocular inflammatory disease that was refractory to conventional immunosuppression. A favorable response to infliximab was seen in six of the patients, with five
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Manuscript no. 220367.
The authors have no proprietary interest in any of the products mentioned in this study.