Differential Effectiveness of Etanercept and Infliximab in the Treatment of Ocular Inflammation
Presented as a poster at: American Academy of Ophthalmology Annual Meeting, October 2005, Chicago, Illinois.
Received 4 December 2005; accepted 6 April 2006. published online 21 September 2006.
Purpose
Anti–tumor necrosis factor α (anti–TNF-α) agents are being used increasingly in refractory inflammatory eye diseases. We reviewed our patients on etanercept and infliximab to determine whether these medications are equally efficacious in controlling ocular inflammation.
Design
Exploratory retrospective analysis.
Participants
Patients with ocular inflammatory disease on an anti–TNF-α agent (etanercept, infliximab).
Methods
Case records of 22 patients treated with anti–TNF-α therapy were reviewed for demographic information, ocular and systemic diagnosis, duration and dose of anti–TNF-α treatment, concomitant ocular and systemic immunosuppressive medications, and treatment response.
Main Outcome Measures
Uveitis recurrence rate, initial treatment response, treatment response, and medication use at 6 months, 1 year, and last visit.
Results
Patients treated with infliximab had a significant decrease in uveitis recurrences after starting therapy compared with those treated with etanercept (59% vs. 0%, P = 0.004). One year after treatment initiation and at final visit, more infliximab-treated patients had an improvement in their ocular inflammation (100% vs. 33%, P = 0.002, and 94% vs. 0%, P<0.001, respectively) and a decreased requirement for topical prednisolone acetate 1% (94% vs. 33%, P = 0.009, and 89% vs. 29%, P = 0.007, respectively) compared with those treated with etanercept. No significant differences in the use of oral corticosteroids and immunosuppressive agents were noted between the 2 groups at 6 months, 1 year, and final visit.
Conclusions
Infliximab was more effective than etanercept in the treatment of recalcitrant uveitis and decreased the use of topical steroids.
1Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio.
2Cornea Service, Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio.
3Uveitis Service, Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio.
4Quantitative Health Science Department, The Cleveland Clinic Foundation, Cleveland, Ohio.
Correspondence to Victor L. Perez, MD, Cole Eye Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk i32, Cleveland, OH 44195.
Manuscript no. 2005-1190.
The authors received no financial support and have no conflict of interest.
ABSTRACT