Rituximab in the Treatment of Refractory Noninfectious Scleritis

Cao, Jennifer H.; Oray, Merih; Cocho, Lidia; Foster, C. Stephen

doi:10.1016/j.ajo.2015.12.032

Cited by 42 publications

(28 citation statements)

References 18 publications

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“…The advent of biologic therapy has revolutionized the management of noninfectious intraocular inflammation. However, most of the reported literature is primarily focused in the treatment of uveitis [14], whereas the efficacy and safety of biologics in scleritis have mainly been addressed by single case reports and small case series [6][7][8][9][10][11]15].…”

Section: Discussionmentioning

confidence: 99%

“…Beyond TNF-α inhibition, a prospective randomized double-masked trial by Suhler et al found that the anti-CD 20 monoclonal antibody rituximab is effective and well tolerated during a 24-week follow-up period [5]. However, only small case series or isolated case reports have been reported on the use of other different biologics [6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

Fabiani

Sota

Maza

et al. 2020

Mediators of Inflammation

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Objective. To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile. Results. Fourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (p=0.002) and from baseline to the last follow-up visit (p=0.002). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.007). No differences regarding BCVA were observed (p=0.67). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment. Conclusions. Our results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

Fabiani

Sota

Maza

et al. 2020

Mediators of Inflammation

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“…The primary difference lies in the standardization of the dosage of rituximab, which was administered at 375 mg/m 2 every week for 8 weeks, then 375 mg/m 2 monthly [50, 51]. Contrastingly, patients in our study were treated with rituximab in a customized fashion based on symptoms and specialist preferences.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of rituximab in non-paraneoplastic autoimmune retinopathy

Boudreault

Justus

Sengillo

et al. 2017

Orphanet J Rare Dis

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BackgroundAutoimmune retinopathy (AIR) is a rare but potentially blinding condition that is often underdiagnosed. Common features in AIR presentation include rapidly progressive vision loss with abnormal electrophysiological responses of the retina associated with positive anti-retinal antibodies. AIR is also challenging to treat, and thus, the introduction of new potential therapeutic agents is welcomed. The goal of this communication is to assess the effects of rituximab infusions on electroretinogram (ERG) responses and visual function outcomes in patients with non-paraneoplastic autoimmune retinopathy (npAIR).ResultsFollowing infusion(s), three out of five patients showed no evidence of disease progression or improved, while two patients continued to progress on ERG. One patient demonstrated improvement in visual acuity (2 lines) in both eyes. ERG responses provided objective monitoring of patients’ visual function and response to immunosuppression over time.ConclusionsThese findings suggest that patients with npAIR unresponsive to other immunosuppression therapies may benefit from rituximab infusion, although stabilization rather than improvement was more frequently the outcome in our case series. Furthermore, regularly scheduled ERG follow-up examinations are recommended for monitoring patients’ progression during treatment.

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“…Rituximab is a chimeric monoclonal antibody that targets the Blymphocyte surface antigen, CD20, and has been effective in the control of ocular inflammation, particularly in scleritis and ocular cicatricial pemphigoid [43][44][45]. In the setting of Sjögren's syndrome, two small, masked trials where participants were randomized to placebo or rituximab showed that symptoms of dryness (including ocular) improved with rituximab [46, 47••].…”

Section: Biologics Rituximabmentioning

confidence: 99%