Efficacy and tolerability of subcutaneous repository corticotropin injection in refractory ocular inflammatory diseases.

IF 2.9 Q1 OPHTHALMOLOGY
Negin Yavari, Hashem Ghoraba, Christopher Or, Zheng Xian Thng, S Saeed Mohammadi, Irmak Karaca, Azadeh Mobasserian, Amir Akhavanrezayat, Anthony Le, Xun Lyu, Anadi Khatri, Woong Sun Yoo, Dalia El Feky, Ngoc Trong Tuong Than, Osama Elaraby, Aim-On Saengsirinavin, Xiaoyan Zhang, Frances Andrea Anover, Ankur Sudhir Gupta, Muhammad Sohail Halim, Louis A Jison, Quan Dong Nguyen
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引用次数: 0

Abstract

Background: Repository corticotropin injection (RCI) has been suggested to exert immunomodulatory and anti-inflammatory effects in ocular inflammation. The index retrospective study aimed to evaluate the efficacy and tolerability of subcutaneous RCI in patients with active scleritis or uveitis.

Main body: Medical records of patients who were diagnosed with different types of active scleritis or uveitis and received RCI for more than six months at a tertiary eye center were reviewed. Patient characteristics including age, sex, comorbidities, clinical findings, treatment details, and adverse events were recorded. A total of 17 eyes of 17 patients were included. Median age was 43 years old and 53% of patients were male. Mean treatment duration was 25.4 ± 15.5 months. Indications for RCI therapy were scleritis (7 anterior and 1 posterior) (47.8%), panuveitis (17.4%), retinal vasculitis (17.4%), chronic/recurrent anterior uveitis (13%), and posterior uveitis (4.35%). RCI was initiated at a dose of 40 to 80 units 3 times weekly. Given the adequate control of inflammation, RCI was successfully discontinued in four patients (23.5%). Prior to RCI therapy, 14 (82.3%) patients were on oral prednisone at an average of 10 mg daily (range 2.5-40 mg), and two (11.7%) patients discontinued prednisone immediately before initiating RCI due to side effects. After six months of therapy, the prednisone dose was reduced in four (23.5%) patients to an average of 3 mg daily (range 1-5 mg) and was stopped in eight (53%) patients. Concomitant immunomodulatory therapies (IMTs) included mycophenolate mofetil (23.5%) and methotrexate (23.5%), and adalimumab (23.5%). Ten patients were on IMTs prior to using RCI, and during the course of treatment, IMT was stopped in two patients and reduced in one. Side effects included insomnia (23%), hypertension (11.7%), lower extremity edema (11.7%), hyperglycemia (11.7%), weight gain (11.7%), and infection (5.8%).

Conclusion: RCI may be considered as a potential therapy with acceptable tolerability for patients with non-infectious scleritis or uveitis.

皮下注射复方促肾上腺皮质激素治疗难治性眼炎的疗效和耐受性。
背景:有研究认为,注射存留促肾上腺皮质激素(RCI)可在眼部炎症中发挥免疫调节和抗炎作用。本研究旨在评估皮下注射促肾上腺皮质激素对活动性巩膜炎或葡萄膜炎患者的疗效和耐受性:主要内容:研究人员查阅了一家三级眼科中心确诊为不同类型的活动性巩膜炎或葡萄膜炎并接受 RCI 治疗超过 6 个月的患者的病历。记录了患者的特征,包括年龄、性别、合并症、临床表现、治疗细节和不良反应。共纳入了 17 名患者的 17 只眼睛。中位年龄为 43 岁,53% 的患者为男性。平均治疗时间为(25.4 ± 15.5)个月。RCI 治疗的适应症包括巩膜炎(7 例前葡萄膜炎和 1 例后葡萄膜炎)(47.8%)、泛葡萄膜炎(17.4%)、视网膜血管炎(17.4%)、慢性/复发性前葡萄膜炎(13%)和后葡萄膜炎(4.35%)。开始使用的 RCI 剂量为 40 至 80 单位,每周 3 次。由于炎症得到了充分控制,4 名患者(23.5%)成功停用了 RCI。在接受 RCI 治疗前,14 名患者(82.3%)平均每天口服 10 毫克(范围为 2.5-40 毫克)泼尼松,其中 2 名患者(11.7%)因副作用在接受 RCI 治疗前立即停用了泼尼松。治疗 6 个月后,4 名患者(23.5%)的泼尼松剂量降至平均每天 3 毫克(1-5 毫克不等),8 名患者(53%)停止使用泼尼松。同时使用的免疫调节疗法(IMT)包括霉酚酸酯(23.5%)、甲氨蝶呤(23.5%)和阿达木单抗(23.5%)。10 名患者在使用 RCI 之前服用了 IMT,在治疗过程中,两名患者停止了 IMT,一名患者减少了 IMT。副作用包括失眠(23%)、高血压(11.7%)、下肢水肿(11.7%)、高血糖(11.7%)、体重增加(11.7%)和感染(5.8%):结论:RCI 可作为非感染性巩膜炎或葡萄膜炎患者的一种潜在疗法,其耐受性可以接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.80
自引率
3.40%
发文量
39
审稿时长
13 weeks
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