Successful ustekinumab treatment of noninfectious uveitis and concomitant severe psoriatic arthritis and plaque psoriasis

Mugheddu, Cristina; Atzori, Laura; Piano, Maria Del; Lappi, Astrid; Pau, Monica; Murgia, Severino; Zucca, Ignazio Alberto; Rongioletti, Franco

doi:10.1111/dth.12527

Cited by 47 publications

(19 citation statements)

References 14 publications

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“…Monoclonal antibodies that block IL-2, IL-6, and IL-23, which all activate JAK-STAT signaling, have been reported to be efficacious in uveitis. 13 , 14 , 15 , 16 This implies that targeting JAK-STAT signaling may be effective in uveitis, but this is the first report of a favorable clinical response of ocular inflammation to tofacitinib. In addition, tofacitinib proved to be effective for a patient with refractory scleritis that was only initially controlled with cyclophosphamide.…”

Section: Discussionmentioning

confidence: 97%

Tofacitinib for refractory uveitis and scleritis

Paley

Karacal

Rao

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeTo report the successful use of tofacitinib in the treatment of refractory uveitis and scleritis.ObservationsTwo patients, one with scleritis and another with anterior and intermediate uveitis, presented with refractory disease after failure of multiple steroid-sparing therapies. Treatment with tofacitinib led to durable resolution of uveitis and scleritis.Conclusions and importanceTofacitinib is a potential novel treatment option for refractory, noninfectious inflammatory eye disease.

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Section: Discussionmentioning

confidence: 97%

Tofacitinib for refractory uveitis and scleritis

Paley

Karacal

Rao

et al. 2019

American Journal of Ophthalmology Case Reports

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“…It is currently being studied in two phase II trials for the treatment of uveitis STELARA (NCT0291116) and STELABEC (NCT02648581) but the results have not been published yet 39,51. However, initial case reports have shown encouraging results 73,74…”

Section: Psoriasis and Uveitismentioning

confidence: 99%

<p>Psoriasis and uveitis: links and risks</p>

Fotiadou

Lazaridou

2019

PTT

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Uveitis, an inflammatory disorder of the mid-portion of the eye, is considered a relatively rare but very serious ocular complication of psoriasis. Data on the specific characteristics of uveitis in the background of psoriasis are extremely limited. The presence of uveitis in the context of psoriasis has been estimated to occur in 7–20% of the psoriasis cases. This incidence tends to be higher in patients suffering from psoriasis and psoriatic arthritis (PsA) or PSA alone. Psoriatic uveitis is usually bilateral, chronic, and severe. In term of pathogenesis, both psoriasis and uveitis are considered as paradigms of T-helper 1/T-helper 17 (Th1/Th17) inflammatory reactions. Certain cytokines such as tumor necrosis factor-α (TNF- α), Interleukin-17 (IL-17), IL-23, and IL-6 play a significant role in the pathogenesis of both psoriasis and uveitis. As uveitis shares common pathogenetic mechanisms with psoriasis in certain circumstances, both diseases may benefit from the same targeted biologic therapies. Undiagnosed and under-treated cases of psoriatic uveitis may cause significant morbidity and even vision loss. Larger prospective studies are needed in order to further investigate the association between these two entities.

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“…149 Several case reports have demonstrated successful use of ustekinumab in the treatment of refractory uveitis secondary to both Behçet disease and psoriatic arthritis. 150,151 A phase 2 clinical trial evaluating the efficacy and safety of ustekinumab for the treatment of Behçet disease (STELABEC study) is currently ongoing (NCT02648581). The common side effects associated with ustekinumab include flu-like symptoms, headache, dizziness and GI symptoms.…”

Section: Ustekinumabmentioning

confidence: 99%

New therapies in development for the management of non‐infectious uveitis: A review

Hassan

Karkhur

Bae

et al. 2019

Clinical Exper Ophthalmology

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Uveitis is a spectrum of inflammatory disorders characterized by ocular inflammation and is one of the leading causes of preventable visual loss. The main aim of the treatment of uveitis is to control the inflammation, prevent recurrences of the disease and preserve vision while minimizing the adverse effects associated with the therapeutic agents. Initial management of uveitis relies heavily on the use of corticosteroids. However, monotherapy with high‐dose corticosteroids is associated with side effects and cannot be maintained long term. Therefore, steroid‐sparing agents are needed to decrease the burden of steroid therapy. Currently, the therapeutic approach for non‐infectious uveitis (NIU) consists of a step‐ladder strategy with the first‐line option being corticosteroids in various formulations followed by the use of first‐, second‐ and third‐line agents in cases with suboptimal steroid response. Unfortunately, the agents currently at our disposal have limitations such as having a narrow therapeutic window along with their own individual potential side‐effect profiles. Therefore, research has been targeted to identify newer drugs as well as new uses for older drugs that target specific pathways in the inflammatory response. Such efforts are made in order to provide targeted and safer therapy with reduced side effects and greater efficacy. Several specially designed molecular antibodies are currently in various phases of investigations that can potentially halt the inflammation in patients with NIU. In the review, we have provided a comprehensive overview of the current and upcoming therapeutic options for patients with NIU.

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Successful ustekinumab treatment of noninfectious uveitis and concomitant severe psoriatic arthritis and plaque psoriasis

Abstract: We report the first successful treatment of noninfectious uveitis with ustekinumab in a patient with severe concomitant psoriasis and psoriatic arthritis who failed to respond to conventional immune suppressants and with contraindications to tumor necrosis factor alpha inhibitors.

Cited by 47 publications

References 14 publications

Tofacitinib for refractory uveitis and scleritis

Tofacitinib for refractory uveitis and scleritis

<p>Psoriasis and uveitis: links and risks</p>

New therapies in development for the management of non‐infectious uveitis: A review

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