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Ocular Immunology and Inflammation Volume 26, 2018 - Issue 6
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Original Articles

Anakinra in the Treatment of Patients with Refractory Scleritis: A Pilot Study

C. BottinDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, FranceCorrespondence[email protected] bahram.bodaghi@aphp
, MD,
A. FelDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD,
N. ButelDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD,
F. DomontDepartment of Internal Medicine and Clinical Immunology, Pitie-Salpetriere Hospital, Paris, France;DHU Inflammation, Immunopathologie, Biotherapie, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD,
A. L. RemondDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD,
L. SaveyDepartment of Internal Medicine and Clinical Immunology, Pitie-Salpetriere Hospital, Paris, France;DHU Inflammation, Immunopathologie, Biotherapie, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD,
V. TouitouDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD, PhD,
J. F. AlexandraDepartment of Internal Medicine, Bichat Hospital, Paris, France
, MD,
P. LeHoangDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD, PhD,
P. CacoubDepartment of Internal Medicine and Clinical Immunology, Pitie-Salpetriere Hospital, Paris, France;DHU Inflammation, Immunopathologie, Biotherapie, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD, PhD,
B. BodaghiDepartment of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France;Centre national de reference maladies oculaires inflammatoires rares, DHU vision et handicap, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD, PhD &
D. SaadounDepartment of Internal Medicine and Clinical Immunology, Pitie-Salpetriere Hospital, Paris, France;DHU Inflammation, Immunopathologie, Biotherapie, Universite Paris VI-Pierre et Marie Curie, Paris, France
, MD, PhD show all
Pages 915-920 | Received 15 Oct 2016, Accepted 22 Feb 2017, Published online: 24 May 2017
 
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ABSTRACT

Purpose: This study aimed to evaluate the safety and efficacy of anakinra for severe and refractory scleritis.

Methods: Ten patients with severe (i.e. at least 2 ocular relapses per year despite treatment) and refractory [i.e. at least to one disease modifying antirheumatic drugs (DMARDS)] scleritis were treated with anakinra (100 mg/day subcutaneously). Scleritis was associated with inflammatory systemic diseases in 60% of cases. The remission rate defined the primary outcome.

Results: Ninety percent of patients were complete responders with a mean follow-up of 19.4 months after starting anakinra. The corticosteroids daily dose decreased from 18.3 ± 4.1 mg to 4.2 ± 4.9 mg, (p < 0.05), at initiation of anakinra and at end of follow-up, respectively. Associated immunosuppressants were stopped in all cases except one. Side effects were observed in 4 patients who did not need anakinra withdrawal.

Conclusions: This pilot study suggests the efficacy of anakinra in patients with refractory scleritis.

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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