Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis.
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 segm...
| Main Authors: | , , , , , , , , , , |
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| 格式: | Journal article |
| 语言: | English |
| 出版: |
2004
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| _version_ | 1826301992707817472 |
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| author | Murphy, C Greiner, K Plskova, J Duncan, L Frost, A Isaacs, J Rebello, P Waldmann, H Hale, G Forrester, J Dick, A |
| author_facet | Murphy, C Greiner, K Plskova, J Duncan, L Frost, A Isaacs, J Rebello, P Waldmann, H Hale, G Forrester, J Dick, A |
| author_sort | Murphy, C |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-07T05:40:46Z |
| format | Journal article |
| id | oxford-uuid:e57dbdf1-0328-4478-901b-57b3cc7fd44e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:40:46Z |
| publishDate | 2004 |
| record_format | dspace |
| spelling | oxford-uuid:e57dbdf1-0328-4478-901b-57b3cc7fd44e2022-03-27T10:24:22ZNeutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e57dbdf1-0328-4478-901b-57b3cc7fd44eEnglishSymplectic Elements at Oxford2004Murphy, CGreiner, KPlskova, JDuncan, LFrost, AIsaacs, JRebello, PWaldmann, HHale, GForrester, JDick, A 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. |
| spellingShingle | Murphy, C Greiner, K Plskova, J Duncan, L Frost, A Isaacs, J Rebello, P Waldmann, H Hale, G Forrester, J Dick, A Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title | Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title_full | Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title_fullStr | Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title_full_unstemmed | Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title_short | Neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis. |
| title_sort | neutralizing tumor necrosis factor activity leads to remission in patients with refractory noninfectious posterior uveitis |
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