Association of Blepharitis and Ectropion With Tumor Necrosis Factor α Inhibitor Treatment in Crohn Disease

Teo, Honeylen Maryl Tiu; Freire, Francesca de Sá; Demirci, Hakan

doi:10.1001/jamaophthalmol.2018.5413

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…Most cases consist of anterior uveitis (AU), although the induction of intermediate uveitis [29], posterior uveitis [30], scleritis [31], and even orbital myositis [32] has been reported. Other ocular adverse events include blepharitis and ectropion [33], optic neuritis [28], visual impairment [34], diplopia [34][35][36], endophthalmitis [37,38], and "sarcoid-like granulomatosis" [39], panuveitis [40], or retinal vasculitis [41].…”

Section: Ocular Adverse Eventsmentioning

confidence: 99%

A review of ocular adverse events of biological anti-TNF drugs

Susanna

Pavésio

2020

J Ophthal Inflamm Infect

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The recent introduction of biological agents has revolutionized the treatment of chronic immune-inflammatory diseases; however, this new therapy did not come without significant side effects. Through large controlled studies indicating decrease in the number of uveitis flares, the role of TNF inhibitors therapy for non-infectious uveitis gained more ground. Paradoxically to its therapeutic effect, there are reports associating these drugs with the onset or recurrence of inflammatory eye disease. A number of studies have suggested possible roles for anti-TNF-α agents in precipitating or worsening an underlying inflammatory process, including the hypothesis of a disequilibrium in cytokine balance, but to date the mechanisms responsible for these adverse events are not fully understood. A PubMed literature search was performed using the following terms: ophthalmic complication, uveitis, inflammatory eye disease, optic neuritis, neuropathy, adverse events, anti-TNF, TNF alpha inhibitor, infliximab, etanercept, adalimumab, golimumab, certolizumab, and biologics. The data presented in this study was mainly derived from the use of TNF inhibitors in rheumatology, essentially because these drugs have been used for a longer period in this medical field. Many of the ocular adverse events reported on this review may be considered a paradoxical effect of anti-TNF therapy. We found a variety of data associating new onset of uveitis with anti-TNF therapy for rheumatic conditions, predominantly under etanercept. In conclusion, although there is increasing data on ocular adverse events, it remains to be seen whether the suggested link between TNF inhibitors and the onset of ocular inflammation is substantiated by more quality data. Nevertheless, the awareness of potential treatment side effects with anti-TNF should be highlighted.

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Section: Ocular Adverse Eventsmentioning

confidence: 99%

A review of ocular adverse events of biological anti-TNF drugs

Susanna

Pavésio

2020

J Ophthal Inflamm Infect

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“…Tumor necrosis factor alpha (TNF-α) inhibitors are commonly used in the treatment of several autoimmune disorders such as rheumatoid arthritis, psoriasis, and Crohn's disease [28]. Although they are effective in controlling inflammation, TNF-α inhibitors have been associated with various ocular side effects, including blepharitis [29,30].…”

Section: Blepharitis and Tnf-α-inhibitorsmentioning

confidence: 99%

“…They both act by binding to TNF-α, thus inhibiting its action and reducing inflammation. The exact mechanism by which TNF-α inhibitors cause blepharitis remains unclear, but it has been suggested that it may be a paradoxical reaction thought to be secondary to genetic susceptibility, dominance of helper T cells types 1 and 17, and excessive immune response from interferon-α overproduction by plasmacytoid dendritic cells [29].…”

Section: Blepharitis and Tnf-α-inhibitorsmentioning

confidence: 99%

Uncommon Blepharitis

Di Zazzo,

Giannaccare,

Villani

et al. 2024

JCM

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Blepharitis is a common chronic inflammatory condition affecting the eyelid margins; the pathophysiology of blepharitis is complex and not fully understood. The disease is anatomically divided into anterior (inflammation of eyelashes) and posterior (meibomian gland dysfunction) types. Diagnosis relies on clinical examination, revealing characteristic features like scurf, vascular changes, and meibomian gland dysfunction. The main goals of blepharitis treatment are symptom relief, recurrence prevention, and complication risk minimization. Treatment options include lid hygiene, topical and systemic antibiotics, topical corticosteroids, and omega-3 supplements. However, it is important to highlight reported cases of blepharitis as side effects of systemic therapies, particularly in the context of chemotherapy, bortezomib, cetuximab, TNFα inhibitors, and dupilumab. It is crucial to monitor patients undergoing such treatments regularly and attentively in order to promptly set up adequate supportive therapy. Of even more importance is future research on the pathophysiological mechanisms responsible for the occurrence of these ocular side effects in order to find a nosological cure for the issue.

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“…Meist handelt es sich dabei um eine Uveitis anterior (UA), doch wurde auch die Auslösung einer intermediären Uveitis [29], einer Uveitis posterior [30], einer Skleritis [31] und sogar einer orbitalen Myositis [32] berichtet. Andere okuläre Nebenwirkungen sind Blepharitis und Ektropium [33], Optikusneuritis [28], Verschlechterung des Sehvermögens [34], Diplopie [34-36], Endophthalmitis [37, 38] und «sarcoid-like granulomatosis» [39], Panuveitis [40] oder retinale Vaskulitis [41].…”

Section: Okuläre Nebenwirkungenunclassified

Okuläre Nebenwirkungen von biologischen Anti-TNF-Medikamenten – eine Übersicht

Susanna

Pavésio

2020

Kompass Ophthalmol

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Biologika • Anti-TNF • Uveitis • Optikusneuritis • okuläre Nebenwirkung • entzündliche Augenerkrankung Zusammenfassung Die kürzlich erfolgte Einführung biologischer Wirkstoffe hat die Behandlung chronischer immuninflammatorischer Erkrankungen revolutioniert, doch ist diese neue Therapie mit erheblichen Nebenwirkungen verbunden. Durch groß angelegte kontrollierte Studien, in denen sich ein Rückgang der Uveitis-Schübe zeigte, hat die Therapie mit Tumornekrosefaktor (TNF)-Hemmern bei nicht infektiöser Uveitis weiter an Bedeutung gewonnen. Es liegen Berichte vor, denen zufolge diese Medikamente paradoxerweise entgegen ihrer therapeutischen Wirkung mit dem Auftreten oder Wiederauftreten von entzündlichen Augenerkrankungen assoziiert sind. Etliche Studien deuten darauf hin, dass Anti-TNF-α-Wirkstoffe bei der Auslösung oder Verschlimmerung eines zugrunde liegenden Entzündungsprozesses eine Rolle spielen könnten, darunter auch die Hypothese eines gestörten Zytokingleichgewichts; die Mechanismen, die für diese Nebenwirkungen verantwortlich sind, sind jedoch noch nicht vollständig geklärt.

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Association of Blepharitis and Ectropion With Tumor Necrosis Factor α Inhibitor Treatment in Crohn Disease

Cited by 7 publications

References 4 publications

A review of ocular adverse events of biological anti-TNF drugs

A review of ocular adverse events of biological anti-TNF drugs

Uncommon Blepharitis

Okuläre Nebenwirkungen von biologischen Anti-TNF-Medikamenten – eine Übersicht

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