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Tytuł:
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New onset or exacerbation of uveitis with infliximab: paradoxical effects?
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Autorzy:
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Iwahashi C; Ophthalmology, Sumitomo Hospital, Osaka, Japan.; Ophthalmology, Kindai University Faculty of Medicine Hospital, Osakasayama, Japan.
Ono H; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
Haruta M; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
Minami T; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
Mashimo H; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
Shimojo H; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
Ohguro N; Ophthalmology, Japan Community Health Care Organization Hospital, Osaka, Japan.
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Źródło:
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BMJ open ophthalmology [BMJ Open Ophthalmol] 2019 Jul 07; Vol. 4 (1), pp. e000250. Date of Electronic Publication: 2019 Jul 07 (Print Publication: 2019).
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: [London] : BMJ Publishing Group Ltd., [2017]-
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References:
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Contributed Indexing:
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Keywords: infliximab; paradoxical effects; tumour necrosis factor; uveitis
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Entry Date(s):
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Date Created: 20190730 Latest Revision: 20220409
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Update Code:
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20240105
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PubMed Central ID:
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PMC6615868
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DOI:
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10.1136/bmjophth-2018-000250
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PMID:
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31355342
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Objective: To report four cases of new onset or exacerbation of uveitis following administration of infliximab.
Methods: This retrospective observational case series includes four patients who developed new onset or exacerbation of uveitis paradoxically during infliximab treatment.
Results: Four patients were assessed, including three women, with a mean age of 33 (14-84) years. Infliximab was introduced for the treatment of scleritis associated with rheumatoid arthritis (two cases), chronic anterior uveitis associated with juvenile idiopathic arthritis (JIA) (one case) and Crohn's disease (one case). Anterior scleritis associated with rheumatoid arthritis successfully improved following infliximab administration; however, macular oedema or dense vitritis paradoxically developed in two cases. In one case, infliximab was switched to tocilizumab. In another case, infliximab was discontinued, and additional corticosteroids and immunosuppressive medications were added. In one patient with JIA, new-onset macular oedema and exacerbation of anterior uveitis were observed during infliximab treatment, so the patient was switched to adalimumab. In the patient with Crohn's disease treated with infliximab, severe vasculitis and macular oedema occurred, requiring intravitreal triamcinolone injection. The patient was switched to adalimumab. Given that these reactions were paradoxical effects of infliximab, infliximab treatment was discontinued in all cases, and additional corticosteroids or immunosuppressive medications were added. All cases remained free of ocular inflammation at the last visit.
Conclusion: Uveitis rarely occurs de novo or is exacerbated during infliximab treatment. Cessation of infliximab led to resolution of this paradoxical adverse effect.
Competing Interests: Competing interests: None declared.
