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Biologics uveitis

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https://www.readbyqxmd.com/read/27904945/-sarcoidosis-and-uveitis-an-update
#1
REVIEW
J G Garweg
Ocular involvement in sarcoidosis is present in up to one third of patients and is frequently manifested before the underlying systemic disease has been diagnosed. With a view to the therapeutic consequences an early diagnosis of the underlying disease is advantageous. In cases of visual loss early diagnostic measures include invasive procedures, such as ultrasound-guided bronchoalveolar lavage and transbronchial biopsy, if nodular conjunctival or cutaneous manifestations which would confirm the diagnosis are not present...
November 30, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/27886802/advancements-in-the-management-of-uveitis
#2
REVIEW
Sergio Schwartzman
Uveitis may exist as a clinical manifestation of an underlying systemic disease or may represent an idiopathic entity, sometimes with a very characteristic pattern. Different forms of uveitis have been defined on the basis of three important variables: chronicity, anatomic location, and underlying etiology. The evolving understanding of the immune system has resulted in a more targeted approach to manage patients with different forms of uveitis, although clearly this approach is at a very early stage. Altered patterns of cellular processing and different cytokine expression, including TNF, IL-1, IL-2, IL-6, and IL17, have been defined in uveitis, and this has laid the pathway for targeted therapy...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27881144/comparison-of-treatment-response-remission-rate-and-drug-adherence-in-polyarticular-juvenile-idiopathic-arthritis-patients-treated-with-etanercept-adalimumab-or-tocilizumab
#3
Gerd Horneff, Ariane Klein, Jens Klotsche, Kirsten Minden, Hans-Iko Huppertz, Frank Weller-Heinemann, Jasmin Kuemmerle-Deschner, Johannes-Peter Haas, Anton Hospach
BACKGROUND: Treatment response, remission rates and compliance in patients with polyarticular juvenile idiopathic arthritis (polyJIA) treated with adalimumab, etanercept, or tocilizumab were analyzed in clinical practice. METHODS: Data collected in the German BIKER registry were analyzed in patients with polyJIA who started treatment with approved biologics, adalimumab, etanercept or tocilizumab, from 2011 to 2015. Baseline patient characteristics, treatment response, safety and drug survival were compared...
November 24, 2016: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/27853889/efficacy-and-safety-of-adalimumab-in-beh%C3%A3-et-s-disease-related-uveitis-a-multicenter-retrospective-observational-study
#4
Claudia Fabiani, Antonio Vitale, Giacomo Emmi, Lorenzo Vannozzi, Giuseppe Lopalco, Silvana Guerriero, Ida Orlando, Rossella Franceschini, Daniela Bacherini, Luca Cimino, Alessandra Soriano, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Gian Marco Tosi, Carlo Salvarani, Luca Cantarini
The study aim was to evaluate the efficacy of adalimumab (ADA) in a large series of Behçet's disease (BD)-related uveitis. We performed a multicenter retrospective observational study including 40 selected patients (66 eyes) receiving ADA. Clinical data were retrospectively analyzed at baseline, at 3 and 12 months of treatment. Primary end point was reduction of ocular inflammatory flares. Secondary end points were improvement of best corrected visual acuity (BCVA), reduction of macular thickness measured by optical coherence tomography (OCT), reduction in the occurrence of vasculitis assessed by fluorescein angiography (FA), and evaluation of statistically significant differences between patients treated with ADA monotherapy and those undergoing ADA plus DMARDs and in patients firstly treated with ADA compared to patients previously administered with other biologics; ADA steroid sparing effect was also evaluated...
November 16, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27843575/effectiveness-and-safety-of-tnf-inhibitors-in-adults-with-juvenile-idiopathic-arthritis
#5
Lianne Kearsley-Fleet, Flora McErlane, Helen E Foster, Mark Lunt, Kath D Watson, Deborah P M Symmons, Kimme L Hyrich
INTRODUCTION: Many children with juvenile idiopathic arthritis (JIA) continue to have active disease into adulthood. Adults with JIA are a heterogeneous group, and the effects of tumour necrosis factor inhibitor (TNFi) therapies are not well described. This analysis aims to describe treatment outcomes among patients with JIA starting TNFi for the first time in adulthood. METHODS: Patients with arthritis onset <16 years starting their first TNFi therapy were identified from the British Society of Rheumatology Biologics Register...
2016: RMD Open
https://www.readbyqxmd.com/read/27805464/a-review-of-the-course-and-treatment-of-non-infectious-uveitis-during-pregnancy
#6
Lindsay A Grotting, George N Papaliodis
Inflammatory conditions such as autoimmune uveitis often occur in women of childbearing age. During pregnancy, women may experience exacerbations of their disease in the first trimester. In the later stages of pregnancy, however, the uveitis tends to remain less active. The management of uveitis during pregnancy is a challenging task, forcing the physician to re-evaluate the patient's current therapy and offer alternative options that pose the least risk to the patient and fetus. This article will review treatments widely used for uveitis, including corticosteroid therapy, anti-metabolites, calcineurin inhibitors, and biologic therapy...
November 2, 2016: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/27800496/serum-hmgb1-serves-as-a-novel-laboratory-indicator-reflecting-disease-activity-and-treatment-response-in-ankylosing-spondylitis-patients
#7
Chenqiong Wang, Ye Miao, Xuefen Wu, Yishu Huang, Mengchen Sun, Yingzi Zhu, Fang Zheng, Wei Sun, Lingli Dong
Objective. High mobility group box 1 (HMGB1) is a late inflammatory factor participating in the pathogenesis of various autoimmune and inflammatory diseases. In the current study, we analyzed the association between serum levels of HMGB1 and clinical features of AS patients before and during treatment. Methods. Serum HMGB1 was detected in 147 AS patients and 61 healthy controls using ELISA. We evaluated the association between HMGB1 and extra-articular manifestations as well as disease severity indices. Among these AS patients, 41 patients received close follow-up at 1, 3, and 6 months after treatment...
2016: Journal of Immunology Research
https://www.readbyqxmd.com/read/27800265/treatment-of-juvenile-idiopathic-arthritis-associated-uveitis
#8
REVIEW
Merih Oray, İlknur Tuğal-Tutkun
Pediatric uveitis may be a serious health problem because of the lifetime burden of vision loss due to severe complications if the problem is not adequately treated. Juvenile idiopathic arthritis (JIA)-associated uveitis is characterized by insidious onset and potentially blinding chronic anterior uveitis. Periodic ophthalmologic screening is of utmost importance for early diagnosis of uveitis. Early diagnosis and proper immunomodulatory treatment are essential for good visual prognosis. The goal of treatment is to achieve enduring drug-free remission...
April 2016: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/27749140/biologic-therapy-for-hla-b27-associated-ocular-disorders
#9
Julie Gueudry, Jennifer E Thorne, Rakesh Bansie, Juergen Braun, P Martin van Hagen, Bahram Bodaghi
The treatment of articular and extra-articular manifestations associated with HLA-B27 has undergone dramatic changes over the past two decades, mainly as a consequence of the introduction of biologic agents and in particular anti-tumor necrosis factor α (anti-TNFα) agents. Uveitis is known to be the most frequent extra-articular feature in HLA-B27-associated spondyloarthritides. Topical corticosteroids and cycloplegic agents remain the cornerstones of treatment. However, biologic therapy may be effective in the management of refractory or recurrent forms of uveitis...
October 17, 2016: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/27723657/recent-developments-in-the-diagnosis-and-treatment-of-ocular-toxoplasmosis
#10
Cem Ozgonul, Cagri Giray Besirli
Ocular toxoplasmosis, a chorioretinal infection with Toxoplasma gondii, is the most common etiology of posterior uveitis in many countries. Accurate diagnosis depends heavily on the characteristic clinical features of this disease, but atypical presentations, especially in immunocompromised patients, may create diagnostic challenges and lead to misdiagnosis and inappropriate treatment. Molecular biology techniques to diagnose ocular toxoplasmosis have been available for many years and are now accessible as standard laboratory tests in many countries...
October 11, 2016: Ophthalmic Research
https://www.readbyqxmd.com/read/27699578/re-initiation-of-biologics-after-the-development-of-tuberculosis-under-anti-tnf-therapy
#11
Yesim Ozguler, Gulen Hatemi, Serdal Ugurlu, Emire Seyahi, Melike Melikoglu, Sermin Borekci, Ersan Atahan, Gul Ongen, Vedat Hamuryudan
The use of anti-TNF agents is associated with an increased risk of tuberculosis (TB) and anti-TNF agents are stopped when active TB develops. However, discontinuation of treatment can result in flare of the underlying disease. The charts of 22 patients who developed active TB among a cohort of 2754 patients using anti-TNF agents between 2001 and 2013 were reviewed retrospectively. Patients restarting biologics during further follow-up were identified. One patient with miliary TB died within 1 month. A biologic agent was restarted in 16 of the remaining 21 patients (76 %)...
December 2016: Rheumatology International
https://www.readbyqxmd.com/read/27698552/profile-of-adalimumab-and-its-potential-in-the-treatment-of-uveitis
#12
Stephen J Balevic, C Egla Rabinovich
Uveitis refers to the presence of intraocular inflammation, and as a strict definition compromises the iris and ciliary body anteriorly and the choroid posteriorly (the uvea). Untreated, uveitis can lead to visual loss or blindness. The etiology of uveitis can include both infectious and noninfectious (usually immune-mediated) causes, the latter of which are often mediated predominantly by Th1 CD4(+) T-cells that secrete proinflammatory cytokines. Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine involved in the pathogenesis of uveitis, which at high concentrations can cause excess inflammation and tissue damage...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27696756/anti-il6-r-tocilizumab-for-severe-juvenile-idiopathic-arthritis-associated-uveitis-refractory-to-anti-tnf-therapy-a-multicenter-study-of-25-patients
#13
Vanesa Calvo-Río, Montserrat Santos-Gómez, Inmaculada Calvo, Ma Isabel González-Fernández, Berta López Montesinos, Marina Mesquida, Alfredo Adán, María Victoria Hernández, Olga Maíz, Antonio Atanes, Beatriz Bravo, Consuelo Modesto, Gisela Díaz-Cordovés, Natalia Palmou-Fontana, Javier Loricera, M C González-Vela, Rosalía Demetrio-Pablo, J L Hernández, Miguel A González-Gay, Ricardo Blanco
OBJECTIVE: To assess the efficacy of Tocilizumab (TCZ) for Juvenile Idiopathic Arthritis (JIA)-associated uveitis. METHODS: Multicenter study of patients with JIA-associated uveitis refractory to conventional immunosuppressive drugs and anti-TNFα agents. RESULTS: We assessed 25 (21 women) patients (47 affected eyes); mean age 18.5±8.3 years. Uveitis was bilateral in 22. Cystoid macular edema (CME) was present in 9 patients. Ocular sequelae found at TCZ onset included: cataracts (13), glaucoma (7), synechiae (10), band keratopathy (12), maculopathy (9), and amblyopia (5)...
October 1, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27633826/comparable-efficacy-of-abatacept-used-as-first-line-or-second-line-biological-agent-for-severe-juvenile-idiopathic-arthritis-related-uveitis
#14
Carolina Birolo, Maria Elisabetta Zannin, Svetlana Arsenyeva, Rolando Cimaz, Elisabetta Miserocchi, Margarita Dubko, Chantal Job Deslandre, Fernanda Falcini, Maria Alessio, Francesco La Torre, Ekaterina Denisova, Giorgia Martini, Irina Nikishina, Francesco Zulian
OBJECTIVE: Abatacept (ABA) has recently been proposed as second-line treatment in patients with juvenile idiopathic arthritis (JIA)-associated uveitis refractory to anti-tumor necrosis factor-α (anti-TNF) agents, but little is known about its efficacy as a first-line approach. The aim of the present study was to compare the safety and efficacy of ABA as a first-line biological agent (ABA-1) with that of ABA as a second-line treatment after 1 or more anti-TNF agents (ABA-2), in patients with severe JIA-related uveitis...
September 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27633821/evidence-for-tocilizumab-as-a-treatment-option-in-refractory-uveitis-associated-with-juvenile-idiopathic-arthritis
#15
Christoph Tappeiner, Marina Mesquida, Alfredo Adán, Jordi Anton, Athimalaipet V Ramanan, Ester Carreno, Friederike Mackensen, Kaisu Kotaniemi, Joke H de Boer, Rosa Bou, Carmen García de Vicuña, Arnd Heiligenhaus
OBJECTIVE: To report on experience using the anti-interleukin 6 receptor antibody tocilizumab (TCZ) to treat severe and therapy-refractory uveitis associated with juvenile idiopathic arthritis (JIA). METHODS: Retrospective data were gathered from patients with JIA receiving TCZ treatment for uveitis. JIA and related uveitis data (disease onset, activity, structural complications, and topical and systemic antiinflammatory treatment) were evaluated at the start of TCZ (baseline) and every 3 months during TCZ therapy...
December 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27540908/sepsis-during-immunosuppression-for-sight-threatening-uveitis-the-flip-side
#16
Nicholas Jones
PURPOSE: To highlight the rare but life-threatening infective consequences of immunosuppression or biologic treatment for sight-threatening uveitis. PATIENTS AND METHODS: Retrospective case series of four immunosuppressed patients with uveitis complicated by sepsis. RESULTS: The affected patients were all treated using prednisolone 10 mg/day or greater, together with oral immunosuppression (2 mycophenolate mofetil, 1 azathioprine + ciclosporin, 1 methotrexate) and, in one case, infliximab...
August 19, 2016: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/27531117/-the-prospects-of-the-biotherapy-for-refractory-uveitis
#17
Y Z Zheng
Noninfectious uveitis is a kind of recurrent autoimmune disease and a major cause of blindness in clinical practice. Corticosteroids are the conventional medication, but have severe side effects for long-term users, and some refractory patients are treated with immunosuppressive agents. Because the pathogenesis of uveitis is related to the autoimmune imbalance mediated by CD4 + T lymphocytes. The macrophages, lymphocytes and some cytokines are involved. The immunomodulatory therapy is targeted to block the lymphocytes, cytokines or their receptors, so as to control the inflammatory damage or minimize the recurrence of the disease...
July 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/27493788/paradoxical-reactions-under-tnf-%C3%AE-blocking-agents-and-other-biological-agents-given-for-chronic-immune-mediated-diseases-an-analytical-and-comprehensive-overview
#18
REVIEW
Éric Toussirot, François Aubin
Paradoxical adverse events (PAEs) have been reported during biological treatment for chronic immune-mediated diseases. PAEs are defined as the occurrence during biological agent therapy of a pathological condition that usually responds to this class of drug. A wide range of PAEs have been reported including dermatological, intestinal and ophthalmic conditions, mainly with antitumour necrosis factor α (TNF-α) agents. True PAEs include psoriasis, Crohn's disease and hidradenitis suppurativa. Other PAEs may be qualified as borderline and include uveitis, scleritis, sarcoidosis and other granulomatous diseases (granuloma annulare, interstitial granulomatous dermatitis), vasculitis, vitiligo and alopecia areata...
2016: RMD Open
https://www.readbyqxmd.com/read/27470062/anti-tnf%C3%AE-treatment-for-hla-b27-positive-ankylosing-spondylitis-related-uveitis
#19
Mirinae Kim, Jae-Yon Won, Seung Yong Choi, Ji Hyeon Ju, Young-Hoon Park
PURPOSE: To assess the long-term efficacy of the most widely used anti-tumor necrosis factor alpha (TNFα) agents for treatment of HLA-B27-positive ankylosing spondylitis (AS)-related uveitis. DESIGN: Retrospective cohort study. METHODS: The medical records of 143 patients with HLA-B27-positive AS who visited Seoul St. Mary's Hospital and were taking an anti-TNFα agent for at least 1 year were studied. Subjects were divided into 3 groups according to anti-TNFα treatment: Group 1 (infliximab, 66), Group 2 (adalimumab, 45), and Group 3 (etanercept, 32)...
October 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27350009/relative-potency-of-tyrosol-in-the-treatment-of-endotoxin-induced-uveitis-in-rats
#20
Kazuaki Sato, Yuko Mihara, Kazutaka Kanai, Yohei Yamashita, Yuya Kimura, Naoyuki Itoh
Tyrosol (Tyr) is a natural phenolic antioxidant with diverse biological activities. We compared the anti-inflammatory effects of intravenously administered Tyr versus prednisolone (PSL) in an endotoxin-induced uveitis (EIU) rat model. Intravenous administration of 100 mg/kg Tyr was performed 2 hr before, simultaneously and 2 hr after lipopolysaccharide (LPS) injection. Tyr treatment was associated with decreased inflammatory cell number, protein concentration, tumor necrosis factor (TNF)-α, PGE2 and NO levels in AqH and improvements in histopathologic evidence of EIU in ocular tissue at 24 hr after LPS injection...
June 26, 2016: Journal of Veterinary Medical Science
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