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New onset or exacerbation of uveitis with infliximab: paradoxical effects?
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 pat...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615868/ https://www.ncbi.nlm.nih.gov/pubmed/31355342 http://dx.doi.org/10.1136/bmjophth-2018-000250 |
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author | Iwahashi, Chiharu Ono, Hikari Haruta, Mami Minami, Takamasa Mashimo, Hisashi Shimojo, Hiroshi Ohguro, Nobuyuki |
author_facet | Iwahashi, Chiharu Ono, Hikari Haruta, Mami Minami, Takamasa Mashimo, Hisashi Shimojo, Hiroshi Ohguro, Nobuyuki |
author_sort | Iwahashi, Chiharu |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6615868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-66158682019-07-28 New onset or exacerbation of uveitis with infliximab: paradoxical effects? Iwahashi, Chiharu Ono, Hikari Haruta, Mami Minami, Takamasa Mashimo, Hisashi Shimojo, Hiroshi Ohguro, Nobuyuki BMJ Open Ophthalmol Original Article 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. BMJ Publishing Group 2019-07-07 /pmc/articles/PMC6615868/ /pubmed/31355342 http://dx.doi.org/10.1136/bmjophth-2018-000250 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Article Iwahashi, Chiharu Ono, Hikari Haruta, Mami Minami, Takamasa Mashimo, Hisashi Shimojo, Hiroshi Ohguro, Nobuyuki New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title | New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title_full | New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title_fullStr | New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title_full_unstemmed | New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title_short | New onset or exacerbation of uveitis with infliximab: paradoxical effects? |
title_sort | new onset or exacerbation of uveitis with infliximab: paradoxical effects? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615868/ https://www.ncbi.nlm.nih.gov/pubmed/31355342 http://dx.doi.org/10.1136/bmjophth-2018-000250 |
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