Anti–Tumor Necrosis Factor α versus Tocilizumab in the Treatment of Refractory Uveitic Macular Edema

Leclercq, M.; Andrillon, Anaïs; Maalouf, G.; Sève, P.; Bielefeld, P.; Gueudry, J.; Sené, Thomas; Moulinet, T.; Rouvière, Bénédicte; Sène, Damien; Desbois, Anne-Claire; Domont, Fanny; Touhami, Sara; Chamieh, Carolla El; Cacoub, P.; Bodaghi, Bahram; Biard, Lucie; Saadoun, David

doi:10.1016/j.ophtha.2021.11.013

Cited by 46 publications

(25 citation statements)

References 35 publications

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“…Two studies were retrospective, concerning 19 patients overall: three who received TCZ for uveitic macular oedema, 14 for ocular involvement and 2 for CNS involvement. (29,32) The remaining 22 articles were case reports or case series on different BD manifestations. Two additional patients with BD from our centre were also included.…”

Section: Resultsmentioning

confidence: 99%

“…One patient who received TCZ for BD uveitis, had also been treated with interferon β, as he also presented neuro-BD and was mis-diagnosed as multiple sclerosis. TCZ was effective in all patients, except two: one patient who received TCZ for chondritis due to MAGIC syndrome and one for uveitic macular oedema (17,32). More specifically, TCZ induced remission in all patients with ocular and neurological manifestations, including one with both ocular and neuro-BD.…”

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 87%

“…Overall, 10 studies reported on 31 anti-TNF naive patients who received TCZ for ocular involvement (n=5), neuro-BD (n=7, one also had panuveitis), vascular involvement (n=16), secondary renal AA amyloidosis (n=2) and MAGIC syndrome (n=1) (17,21,22,25,26,28,29,(31)(32)(33) (Table I). All patients had previously been treated with corticosteroids combined with various immunosuppressants, except of one patient who had only received lowdose corticosteroids.…”

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 99%

“…More specifically, TCZ induced remission in all patients with ocular and neurological manifestations, including one with both ocular and neuro-BD. One patient with bilateral panuveitis and uveitic macular oedema, although he initially had a partial response to TCZ, experienced a relapse and had to discontinue treatment (32). Two pa-tients with neuro-BD had complete remission of neurologic symptoms, and one was able to discontinue concomitant corticosteroids.…”

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 99%

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IL-6 blockade for Behçet's disease: review on 31 anti-TNF naïve and 45 anti-TNF experienced patients

Arida

Saadoun

Sfikakis

2022

Clinical and Experimental Rheumatology

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Objective. Despite the remarkable efficacy of anti-TNF agents in Behçet's disease (BD), unmet therapeutic needs for refractory or intolerant patients to these drugs still exist. Based on evidence implicating IL-6 in the pathogenesis of BD, we summarise the current experience on the off-label administration of the anti-IL-6 receptor antibody tocilizumab for BD refractory to disease-modifying anti-rheumatic drugs. Methods. We searched PubMed and EMBASE for original articles published through December 2021 reporting on the use of tocilizumab for BD. Results. We retrieved 25 articles fulfilling our search criteria, reporting on a total of 74 patients of whom 31 were anti-TNF naive; 2 additional anti-TNF experienced patients were included. The vast majority (72 of 76) received the standard intravenous dose of tocilizumab, whereas the total follow-up, including also post-treatment follow-up in many patients, ranged from 2 to 84 months without new safety issues. Tocilizumab was given in anti-TNF naive patients predominantly for vascular (n=16), central nervous system (n=7) and ocular involvement (n=5). On the other hand, anti-TNF experienced patients received tocilizumab predominantly for ocular (n=28), central nervous system (n=8) and mucocutaneous involvement (n=6). Tocilizumab was effective in 87% of anti-TNF naive (13 and 14 with complete and partial remission, respectively) and in 80% of anti-TNF experienced patients (17 and 19 with complete and partial remission, respectively). Conclusion. Although preliminary, evidence published so far suggests that IL-6 inhibition is a legitimate therapeutic option for BD patients with refractory ocular, CNS and vascular involvement. Controlled studies are clearly needed.

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Section: Resultsmentioning

confidence: 99%

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 87%

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 99%

Section: Efficacy In Anti-tnf Naive Patientsmentioning

confidence: 99%

See 2 more Smart Citations

IL-6 blockade for Behçet's disease: review on 31 anti-TNF naïve and 45 anti-TNF experienced patients

Arida

Saadoun

Sfikakis

2022

Clinical and Experimental Rheumatology

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“…Although the incidence of COVID-19 was increased compared to the general population, the outcome was mild with no increased mortality or thrombotic events. (94). Thirty-five patients (17%) had BS and only 3 received tocilizumab.…”

Section: Covid-19mentioning

confidence: 99%

Behçet's syndrome: one year in review 2022

Hatemi

Seyahi

Fresko

et al. 2022

Clinical and Experimental Rheumatology

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This review highlights publications on different aspects of Behçet's syndrome (BS) that appeared in 2021 and provides a critical view. These publications include works on the epidemiology of BS across different continents, newly developed instruments to assess damage in BS, studies highlighting the immunopathogenesis, genetics and epigenetic factors, histopathology of the pathergy lesion, clinical and imaging aspects of vascular involvement, and safety and efficacy of therapeutic agents including tocilizumab, apremilast and direct oral anticoagulants.

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Inflammatory cytokines as mediators of retinal endothelial barrier dysfunction in non‐infectious uveitis

Ferreira,

Williams,

Best

et al. 2023

Clin & Trans Imm

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Characterised by intraocular inflammation, non‐infectious uveitis includes a large group of autoimmune and autoinflammatory diseases that either involve the eye alone or have both ocular and systemic manifestations. When non‐infectious uveitis involves the posterior segment of the eye, specifically the retina, there is substantial risk of vision loss, often linked to breakdown of the inner blood‐retinal barrier. This barrier is formed by non‐fenestrated retinal vascular endothelial cells, reinforced by supporting cells that include pericytes, Müller cells and astrocytes. Across the published literature, a group of inflammatory cytokines stand out as prominent mediators of intraocular inflammation, with effects on the retinal endothelium that may contribute to breakdown of the inner blood‐retinal barrier, namely tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐6, IL‐8, IL‐17 and chemokine C‐C motif ligand (CCL)2. This article reviews the function of each cytokine and discusses the evidence for their involvement in retinal endothelial barrier dysfunction in non‐infectious uveitis, including basic laboratory investigations, studies of ocular fluids collected from patients with non‐infectious uveitis, and results of clinical treatment trials. The review also outlines gaps in knowledge in this area. Understanding the disease processes at a molecular level can suggest treatment alternatives that are directed against appropriate biological targets to protect the posterior segment of eye and preserve vision in non‐infectious uveitis.

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Anti–Tumor Necrosis Factor α versus Tocilizumab in the Treatment of Refractory Uveitic Macular Edema

Cited by 46 publications

References 35 publications

IL-6 blockade for Behçet's disease: review on 31 anti-TNF naïve and 45 anti-TNF experienced patients

IL-6 blockade for Behçet's disease: review on 31 anti-TNF naïve and 45 anti-TNF experienced patients

Behçet's syndrome: one year in review 2022

Inflammatory cytokines as mediators of retinal endothelial barrier dysfunction in non‐infectious uveitis

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