Efficacy and safety of TNF antagonists in ocular sarcoidosis: data from the French registry STAT

Efficacy and safety of TNF antagonists in ocular sarcoidosis: data from the French registry STAT

Authors

  • Alicia Marquet Hospices Civils de Lyon, France
  • Catherine Chapelon-Abric Département de Médecine Interne et d'Immunologie Clinique II, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Pitié Salpêtrière, France
  • Delphine Maucort-Boulch Hospices Civils de Lyon, France
  • Fleur Cohen-Aubart Département de Médecine Interne et d'Immunologie Clinique, AP-HP, Paris, France
  • Laurent Pérard Hospices Civils de Lyon, France
  • Laurence Bouillet Centre Hospitalier Universitaire de Grenoble, France
  • Sébastien Abad Département de Médecine Interne, Hôpital Avicenne, Bobigny, France
  • Philip Biellefeld Centre Hospitalier Universitaire de Dijon, France
  • Diane Bouvry Département de Pneumologie, Hôpital Avicenne, Bobigny, France
  • Marc André Centre Hospitalier Universitaire de Clermont-Ferrand, France
  • Nicolas Noël Département de Médecine Interne et d'Immunologie Clinique, AP-HP, Le Kremlin Bicêtre, France
  • Boris Bienvenu Centre Hospitalier Universitaire de Caen, France
  • Alice Proux Département de Médecine Interne de Gériatrie Thérapeutique, CHU de Rouen, France
  • Sandra Vukusic Hospices Civils de Lyon, France
  • Bahram Bodaghi Département d'Ophtalmologie, AP-HP, Paris, France
  • Françoise Sarrot-Reynauld Centre Hospitalier Universitaire de Grenoble, France
  • Jean Iwaz Hospices Civils de Lyon, France
  • Christiane Broussolle Hospices Civils de Lyon, France
  • David Saadoun Département de Médecine Interne et d'Immunologie Clinique II, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Pitié Salpêtrière, France
  • Yvan Jamilloux Hospices Civils de Lyon, France
  • Dominique Valeyre Département de Pneumologie, Hôpital Avicenne, Bobigny, France
  • Pascal Sève Hospices Civils de Lyon, France
  • Groupe Sarcoidose Francophone

Keywords:

efficacy, safety, sarcoidosis, TNF antagonists, uveitis

Abstract

Backgroung: This study investigated the efficacy and safety of TNF antagonists in sarcoid uveitis in unselected cases. Design: This is a multicentre study on patients with sarcoidosis who received TNF antagonists in pneumology and internal medicine departments in France. We present here the subgroup of patients with biopsy-proven sarcoid uveitis included in the nationwide registry STAT (Sarcoidosis treated with TNF AnTagonists). Results: Among the 132 patients included in this multicenter study, 18 patients with refractory uveitis were treated as a first-line TNF antagonist with infliximab (n=14), adalimumab (n=3) and certolizumab (n=1). Before anti-TNF initiation, the median duration of sarcoidosis was 42 months and 83% of the patients have been treated with at least one immunosuppressive drug. Six patients switched for a second-line TNF antagonist. After a mean time under treatment of 29 months, the treatment resulted in a significant decrease of the ophthalmic extrapulmonary Physician Organ Severity Tool (ePOST) (mean score: 4.2 vs. 2.6) scores and a steroid sparing effect (29.4±20.7 vs. 6.2±5.2 mg/d). Overall, the ophthalmic response, either complete or partial, was 67%. Nine patients (50%) presented adverse events, including severe infectious complications in 5 patients, which required anti-TNF treatment interruption in 6 cases (33%). Among the 7 responder patients who discontinued anti-TNF therapy, 71% relapsed. Finally, 12 patients (67%) could continue TNF antagonist treatment. Conclusions: TNF antagonists were efficient in 67% of biopsy-proven refractory sarcoid uveitis. Severe adverse events, mainly infectious complications, were frequent. The high frequency of relapses after anti-TNF-α discontinuation requires a close patient follow-up thereafter. 

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Published

28-04-2017

Issue

Section

Original Articles: Clinical Research

How to Cite

1.
Marquet A, Chapelon-Abric C, Maucort-Boulch D, Cohen-Aubart F, Pérard L, Bouillet L, et al. Efficacy and safety of TNF antagonists in ocular sarcoidosis: data from the French registry STAT. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2017 Apr. 28 [cited 2025 Mar. 7];34(1):74-80. Available from: https://mattioli1885journals.com/index.php/sarcoidosis/article/view/5368