For a study, researchers sought to investigate the variables related to response (ocular inflammation control and corticosteroid-sparing effect) to biologics (anti-tumor necrosis factor [TNF]-agents and tocilizumab) in patients with refractory uveitic macular edema (ME). The trial comprised adult patients with uveitic ME who were unresponsive to systemic corticosteroids, disease-modifying antirheumatic medications, or both. Anti–TNF medications (infliximab 5 mg/kg at weeks 0, 2, 6, and every 4–6 weeks [n=69] and adalimumab 40 mg/2 weeks [n=80]) and tocilizumab (8 mg/kg every 4 weeks intravenously [n=39] and 162 mg/week subcutaneously [n=16]) were administered to the patients. At 6 months, investigators looked at the full and partial response rates, relapse rate, poor vision (visual acuity in at least one eye of 1 logarithm of the lowest angle of resolution), corticosteroid-sparing impact, and side events.
There were 204 patients (median age, 40 years [interquartile range, 28–58 years]; 42.2% men). The most common causes of uveitis were Behçet’s illness (17.2%), birdshot chorioretinopathy (11.3%), and sarcoidosis (7.4%). At 6 months, the total response rate with anti–TNF-agents was 46.2% (21.8% complete response) and 58.5% (35.8% full response) with tocilizumab. Treatment with tocilizumab (odds ratio, 2.10; 95% CI, 1.06–4.06; P=0.03) was related to the full response of uveitic ME in the multivariate analysis compared to anti–TNF-agents. In terms of relapse rate (hazard ratio, 1.00; 95% CI, 0.31–3.18; P=0.99) or occurrence of poor vision (odds ratio, 1.02; 95% CI, 0.51–2.07; P=0.95) or corticosteroid-sparing impact (P=0.29), anti–TNF-agents and tocilizumab did not vary substantially. A total of 20.6%of patients reported adverse events, with 10.8% reporting severe adverse events.
Reference:www.aaojournal.org/article/S0161-6420(21)00900-3/fulltext
