Neutralising tumor necrosis factor activity leads to remission in patients with refractory non-infections posterior uveitis

C. C. Murphy, Kathrin Greiner, Jarka Plskova, Linda Duncan, A. Frost, J. D. Isaacs, P. Rebello, H. Waldmann, G. Hale, John Vincent Forrester, A. D. Dick

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibition with the p55 TNF receptor fusion protein (TNFr-Ig) for severe sight-threatening noninfectious posterior segment intraocular inflammation.

Methods: Seventeen patients with refractory noninfectious posterior segment intraocular inflammation received TNFr-Ig by intravenous infusion in this nonrandomized, open-label, pilot study. The primary outcome measure was logMAR visual acuity. Secondary outcome measures were binocular indirect ophthalmoscopy score, cystoid macular edema, adverse effects, and vision-related (visual core module 1) and health-related (36-Item Short-Form Health Survey) quality of life.

Results: Within 1 month of TNFr-Ig therapy, 9 patients (53%) achieved at least a 2-line improvement in visual acuity, 8 (57%) of 14 patients with vitreous haze before treatment achieved an improvement in binocular indirect ophthalmoscopy score to 0, and macular edema resolved in 5 (56%) of 9 affected patients. Twelve (71%) of the patients achieved complete cessation of intraocular inflammation following TNFr-Ig therapy. A reduction in concomitant immunosuppression was possible for 11 patients (65%) following TNFr-Ig therapy. However, all but 1 patient required continuing adjuvant therapy during the response to TNFr-Ig, which had a median duration of 3 months. Adverse effects included mild infusion reactions in 3 patients and transient lymphocytopenia in 2 patients.

Conclusion: Therapy with TNFr-Ig was safe and effective for treating patients with sight-threatening noninfectious posterior segment intraocular inflammation resistant to conventional immunotherapy, but adjuvant immunosuppression and repeat infusions would be required to maintain long-term remission.

Original languageEnglish
Pages (from-to)845-851
Number of pages6
JournalArchives of Ophthalmology
Volume122
Issue number9
DOIs
Publication statusPublished - 2004

Keywords

  • EXPERIMENTAL AUTOIMMUNE UVEORETINITIS
  • CHIMERIC MONOCLONAL-ANTIBODY
  • OCULAR INFLAMMATORY DISEASE
  • FACTOR-ALPHA
  • RHEUMATOID-ARTHRITIS
  • GLOBULIN RESPONSES
  • FACTOR RECEPTOR
  • INFLIXIMAB
  • THERAPY
  • TNF

Cite this

Neutralising tumor necrosis factor activity leads to remission in patients with refractory non-infections posterior uveitis. / Murphy, C. C.; Greiner, Kathrin; Plskova, Jarka; Duncan, Linda; Frost, A.; Isaacs, J. D.; Rebello, P.; Waldmann, H.; Hale, G.; Forrester, John Vincent; Dick, A. D.

In: Archives of Ophthalmology, Vol. 122, No. 9, 2004, p. 845-851.

Research output: Contribution to journalArticle

Murphy, CC, Greiner, K, Plskova, J, Duncan, L, Frost, A, Isaacs, JD, Rebello, P, Waldmann, H, Hale, G, Forrester, JV & Dick, AD 2004, 'Neutralising tumor necrosis factor activity leads to remission in patients with refractory non-infections posterior uveitis', Archives of Ophthalmology, vol. 122, no. 9, pp. 845-851. https://doi.org/10.1001/archopht.122.6.845
Murphy, C. C. ; Greiner, Kathrin ; Plskova, Jarka ; Duncan, Linda ; Frost, A. ; Isaacs, J. D. ; Rebello, P. ; Waldmann, H. ; Hale, G. ; Forrester, John Vincent ; Dick, A. D. / Neutralising tumor necrosis factor activity leads to remission in patients with refractory non-infections posterior uveitis. In: Archives of Ophthalmology. 2004 ; Vol. 122, No. 9. pp. 845-851.
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abstract = "Objective: To evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibition with the p55 TNF receptor fusion protein (TNFr-Ig) for severe sight-threatening noninfectious posterior segment intraocular inflammation.Methods: Seventeen patients with refractory noninfectious posterior segment intraocular inflammation received TNFr-Ig by intravenous infusion in this nonrandomized, open-label, pilot study. The primary outcome measure was logMAR visual acuity. Secondary outcome measures were binocular indirect ophthalmoscopy score, cystoid macular edema, adverse effects, and vision-related (visual core module 1) and health-related (36-Item Short-Form Health Survey) quality of life.Results: Within 1 month of TNFr-Ig therapy, 9 patients (53{\%}) achieved at least a 2-line improvement in visual acuity, 8 (57{\%}) of 14 patients with vitreous haze before treatment achieved an improvement in binocular indirect ophthalmoscopy score to 0, and macular edema resolved in 5 (56{\%}) of 9 affected patients. Twelve (71{\%}) of the patients achieved complete cessation of intraocular inflammation following TNFr-Ig therapy. A reduction in concomitant immunosuppression was possible for 11 patients (65{\%}) following TNFr-Ig therapy. However, all but 1 patient required continuing adjuvant therapy during the response to TNFr-Ig, which had a median duration of 3 months. Adverse effects included mild infusion reactions in 3 patients and transient lymphocytopenia in 2 patients.Conclusion: Therapy with TNFr-Ig was safe and effective for treating patients with sight-threatening noninfectious posterior segment intraocular inflammation resistant to conventional immunotherapy, but adjuvant immunosuppression and repeat infusions would be required to maintain long-term remission.",
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T1 - Neutralising tumor necrosis factor activity leads to remission in patients with refractory non-infections posterior uveitis

AU - Murphy, C. C.

AU - Greiner, Kathrin

AU - Plskova, Jarka

AU - Duncan, Linda

AU - Frost, A.

AU - Isaacs, J. D.

AU - Rebello, P.

AU - Waldmann, H.

AU - Hale, G.

AU - Forrester, John Vincent

AU - Dick, A. D.

PY - 2004

Y1 - 2004

N2 - Objective: To evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibition with the p55 TNF receptor fusion protein (TNFr-Ig) for severe sight-threatening noninfectious posterior segment intraocular inflammation.Methods: Seventeen patients with refractory noninfectious posterior segment intraocular inflammation received TNFr-Ig by intravenous infusion in this nonrandomized, open-label, pilot study. The primary outcome measure was logMAR visual acuity. Secondary outcome measures were binocular indirect ophthalmoscopy score, cystoid macular edema, adverse effects, and vision-related (visual core module 1) and health-related (36-Item Short-Form Health Survey) quality of life.Results: Within 1 month of TNFr-Ig therapy, 9 patients (53%) achieved at least a 2-line improvement in visual acuity, 8 (57%) of 14 patients with vitreous haze before treatment achieved an improvement in binocular indirect ophthalmoscopy score to 0, and macular edema resolved in 5 (56%) of 9 affected patients. Twelve (71%) of the patients achieved complete cessation of intraocular inflammation following TNFr-Ig therapy. A reduction in concomitant immunosuppression was possible for 11 patients (65%) following TNFr-Ig therapy. However, all but 1 patient required continuing adjuvant therapy during the response to TNFr-Ig, which had a median duration of 3 months. Adverse effects included mild infusion reactions in 3 patients and transient lymphocytopenia in 2 patients.Conclusion: Therapy with TNFr-Ig was safe and effective for treating patients with sight-threatening noninfectious posterior segment intraocular inflammation resistant to conventional immunotherapy, but adjuvant immunosuppression and repeat infusions would be required to maintain long-term remission.

AB - Objective: To evaluate the efficacy and safety of tumor necrosis factor (TNF) inhibition with the p55 TNF receptor fusion protein (TNFr-Ig) for severe sight-threatening noninfectious posterior segment intraocular inflammation.Methods: Seventeen patients with refractory noninfectious posterior segment intraocular inflammation received TNFr-Ig by intravenous infusion in this nonrandomized, open-label, pilot study. The primary outcome measure was logMAR visual acuity. Secondary outcome measures were binocular indirect ophthalmoscopy score, cystoid macular edema, adverse effects, and vision-related (visual core module 1) and health-related (36-Item Short-Form Health Survey) quality of life.Results: Within 1 month of TNFr-Ig therapy, 9 patients (53%) achieved at least a 2-line improvement in visual acuity, 8 (57%) of 14 patients with vitreous haze before treatment achieved an improvement in binocular indirect ophthalmoscopy score to 0, and macular edema resolved in 5 (56%) of 9 affected patients. Twelve (71%) of the patients achieved complete cessation of intraocular inflammation following TNFr-Ig therapy. A reduction in concomitant immunosuppression was possible for 11 patients (65%) following TNFr-Ig therapy. However, all but 1 patient required continuing adjuvant therapy during the response to TNFr-Ig, which had a median duration of 3 months. Adverse effects included mild infusion reactions in 3 patients and transient lymphocytopenia in 2 patients.Conclusion: Therapy with TNFr-Ig was safe and effective for treating patients with sight-threatening noninfectious posterior segment intraocular inflammation resistant to conventional immunotherapy, but adjuvant immunosuppression and repeat infusions would be required to maintain long-term remission.

KW - EXPERIMENTAL AUTOIMMUNE UVEORETINITIS

KW - CHIMERIC MONOCLONAL-ANTIBODY

KW - OCULAR INFLAMMATORY DISEASE

KW - FACTOR-ALPHA

KW - RHEUMATOID-ARTHRITIS

KW - GLOBULIN RESPONSES

KW - FACTOR RECEPTOR

KW - INFLIXIMAB

KW - THERAPY

KW - TNF

U2 - 10.1001/archopht.122.6.845

DO - 10.1001/archopht.122.6.845

M3 - Article

VL - 122

SP - 845

EP - 851

JO - Archives of Ophthalmology

JF - Archives of Ophthalmology

SN - 0003-9950

IS - 9

ER -