Anti-Tumor Necrosis Factor α versus Tocilizumab in the Treatment of Refractory Uveitic Macular Edema : A Multicenter Study from the French Uveitis Network
Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved..
PURPOSE: To analyze the factors associated with response (control of ocular inflammation and corticosteroid-sparing effect) to biologics (anti-tumor necrosis factor [TNF]-α agents and tocilizumab) in patients with refractory uveitic macular edema (ME).
DESIGN: Multicenter, retrospective, observational study.
PARTICIPANTS: Adult patients with uveitic ME refractory to systemic corticosteroids, disease-modifying antirheumatic drugs, or both.
METHODS: Patients received anti-TNF-α agents (infliximab 5 mg/kg at week 0, 2, 6, and every 4-6 weeks [n = 69] and adalimumab 40 mg/2 weeks [n = 80]) and tocilizumab (8 mg/kg every 4 weeks intravenously [n = 39] and 162 mg/week subcutaneously [n = 16]).
MAIN OUTCOME MEASURES: Analysis of complete and partial response rates, relapse rate, low vision (visual acuity in at least 1 eye of ≥ 1 logarithm of the minimum angle of resolution), corticosteroid-sparing effect, and adverse events at 6 months.
RESULTS: Two hundred four patients (median age, 40 years [interquartile range, 28-58 years]; 42.2% men) were included. Main causes of uveitis included Behçet's disease (17.2%), birdshot chorioretinopathy (11.3%), and sarcoidosis (7.4%). The overall response rate at 6 months was 46.2% (21.8% of complete response) with anti-TNF-α agents and 58.5% (35.8% of complete response) with tocilizumab. In multivariate analysis, treatment with tocilizumab (odds ratio, 2.10; 95% confidence interval [CI], 1.06-4.06; P = 0.03) was associated independently with complete response of uveitic ME compared with anti-TNF-α agents. Anti-TNF-α agents and tocilizumab did not differ significantly in terms of relapse rate (hazard ratio, 1.00; 95% CI, 0.31-3.18; P = 0.99) or occurrence of low vision (odds ratio, 1.02; 95% CI, 0.51-2.07; P = 0.95) or corticosteroid-sparing effect (P = 0.29). Adverse events were reported in 20.6% of patients, including serious adverse events reported in 10.8% of patients.
CONCLUSIONS: Tocilizumab seems to improve complete response of uveitic ME compared with anti-TNF-α agents.
| Errataetall: |
CommentIn: Ophthalmology. 2022 Jul;129(7):e77. - PMID 35346510 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:129 |
|---|---|
| Enthalten in: |
Ophthalmology - 129(2022), 5 vom: 15. Mai, Seite 520-529 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Leclercq, Mathilde [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 26.04.2022 Date Revised 15.07.2022 published: Print-Electronic CommentIn: Ophthalmology. 2022 Jul;129(7):e77. - PMID 35346510 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ophtha.2021.11.013 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM333312384 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM333312384 | ||
| 003 | DE-627 | ||
| 005 | 20231225221412.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ophtha.2021.11.013 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1110.xml |
| 035 | |a (DE-627)NLM333312384 | ||
| 035 | |a (NLM)34793830 | ||
| 035 | |a (PII)S0161-6420(21)00900-3 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Leclercq, Mathilde |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Anti-Tumor Necrosis Factor α versus Tocilizumab in the Treatment of Refractory Uveitic Macular Edema |b A Multicenter Study from the French Uveitis Network |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.04.2022 | ||
| 500 | |a Date Revised 15.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Ophthalmology. 2022 Jul;129(7):e77. - PMID 35346510 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To analyze the factors associated with response (control of ocular inflammation and corticosteroid-sparing effect) to biologics (anti-tumor necrosis factor [TNF]-α agents and tocilizumab) in patients with refractory uveitic macular edema (ME) | ||
| 520 | |a DESIGN: Multicenter, retrospective, observational study | ||
| 520 | |a PARTICIPANTS: Adult patients with uveitic ME refractory to systemic corticosteroids, disease-modifying antirheumatic drugs, or both | ||
| 520 | |a METHODS: Patients received anti-TNF-α agents (infliximab 5 mg/kg at week 0, 2, 6, and every 4-6 weeks [n = 69] and adalimumab 40 mg/2 weeks [n = 80]) and tocilizumab (8 mg/kg every 4 weeks intravenously [n = 39] and 162 mg/week subcutaneously [n = 16]) | ||
| 520 | |a MAIN OUTCOME MEASURES: Analysis of complete and partial response rates, relapse rate, low vision (visual acuity in at least 1 eye of ≥ 1 logarithm of the minimum angle of resolution), corticosteroid-sparing effect, and adverse events at 6 months | ||
| 520 | |a RESULTS: Two hundred four patients (median age, 40 years [interquartile range, 28-58 years]; 42.2% men) were included. Main causes of uveitis included Behçet's disease (17.2%), birdshot chorioretinopathy (11.3%), and sarcoidosis (7.4%). The overall response rate at 6 months was 46.2% (21.8% of complete response) with anti-TNF-α agents and 58.5% (35.8% of complete response) with tocilizumab. In multivariate analysis, treatment with tocilizumab (odds ratio, 2.10; 95% confidence interval [CI], 1.06-4.06; P = 0.03) was associated independently with complete response of uveitic ME compared with anti-TNF-α agents. Anti-TNF-α agents and tocilizumab did not differ significantly in terms of relapse rate (hazard ratio, 1.00; 95% CI, 0.31-3.18; P = 0.99) or occurrence of low vision (odds ratio, 1.02; 95% CI, 0.51-2.07; P = 0.95) or corticosteroid-sparing effect (P = 0.29). Adverse events were reported in 20.6% of patients, including serious adverse events reported in 10.8% of patients | ||
| 520 | |a CONCLUSIONS: Tocilizumab seems to improve complete response of uveitic ME compared with anti-TNF-α agents | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Anti–tumor necrosis factor α agents | |
| 650 | 4 | |a Efficacy | |
| 650 | 4 | |a Safety | |
| 650 | 4 | |a Tocilizumab | |
| 650 | 4 | |a Uveitic macular edema | |
| 650 | 7 | |a Antibodies, Monoclonal, Humanized |2 NLM | |
| 650 | 7 | |a Tumor Necrosis Factor Inhibitors |2 NLM | |
| 650 | 7 | |a Tumor Necrosis Factor-alpha |2 NLM | |
| 650 | 7 | |a tocilizumab |2 NLM | |
| 650 | 7 | |a I031V2H011 |2 NLM | |
| 700 | 1 | |a Andrillon, Anaïs |e verfasserin |4 aut | |
| 700 | 1 | |a Maalouf, Georgina |e verfasserin |4 aut | |
| 700 | 1 | |a Sève, Pascal |e verfasserin |4 aut | |
| 700 | 1 | |a Bielefeld, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Gueudry, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Sené, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Moulinet, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Rouvière, Bénédicte |e verfasserin |4 aut | |
| 700 | 1 | |a Sène, Damien |e verfasserin |4 aut | |
| 700 | 1 | |a Desbois, Anne-Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Domont, Fanny |e verfasserin |4 aut | |
| 700 | 1 | |a Touhami, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a El Chamieh, Carolla |e verfasserin |4 aut | |
| 700 | 1 | |a Cacoub, Patrice |e verfasserin |4 aut | |
| 700 | 1 | |a Bodaghi, Bahram |e verfasserin |4 aut | |
| 700 | 1 | |a Biard, Lucie |e verfasserin |4 aut | |
| 700 | 1 | |a Saadoun, David |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Ophthalmology |d 1993 |g 129(2022), 5 vom: 15. Mai, Seite 520-529 |w (DE-627)NLM000457019 |x 1549-4713 |7 nnns |
| 773 | 1 | 8 | |g volume:129 |g year:2022 |g number:5 |g day:15 |g month:05 |g pages:520-529 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ophtha.2021.11.013 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 129 |j 2022 |e 5 |b 15 |c 05 |h 520-529 | ||