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This abstract is assigned to session AOB FP
TitleFollow-up of uveitis patients treated with anti-TNFα and causes of treatment withdrawal
PurposeTo study the efficiency of anti-TNFα among a cohort of non-infectious uveitis patients. Likewise,to analyze the therapeutic options in patients resistant to anti-TNFα and their clinical evolution after treatment switch.
MethodsMulticenter, retrospective study. We included all anti-TNFα treated patients seen in the department of ophthalmology of Iris network with non-infectious uveitis. Anti-TNFα efficiency was evaluated by clinical inflammatory parameters (visual acuity, anterior chamber cells, vitritis, macular edema, choroiditis, retinitis) and the reduction of the corticosteroid and immunosuppressive drugs doses, over 6 months. In the patients where anti-TNFα was stopped, the same parameters were analyzed after drug withdrawal.
Results28 patients were included. In all of them, anti-TNFα was introduced in the setting of active disease resistant to conventional therapy. 21 patients responded well to the treatment. Anti-TNFα was stopped in 7 patients for: lack of efficacy, loss of efficacy, side effects and healed disease. Tocilizumab was given as an alternative treatment to 5 patients. Before Tocilizumab, the mean central foveal thickness was 384±109µm and decreased to 298±42µm (p=0.02) at month 3; mean logMAR best-corrected visual acuity was 0.17±0.21 then 0.08±0.09 at month 3 (p=0.29). After 3 months, in tocilizumab patients, all inflammatory parameters were improved and immunosuppressive drugs doses were reduced.
ConclusionThe study confirmed that anti-TNFα therapy is efficient in patients with sight-threatening uveitis resistant to conventional immunomodulatory therapy. Lack or loss of efficacy was the main reason for treatment withdrawal. In those patients, shifting to Tocilizumab seems a promising option.
Conflict of interestYes
Details of conflicting interestsPr Willermain a fait un avis d'expert pour Remicade et Humira
Authors 1
Last nameLE
DepartmentRéseau IRIS
Authors 2
Last nameWillermain
DepartmentRéseau IRIS
Authors 3
Last nameet Al
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