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

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. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 74-80).

• Authors: Alicia Marquet, Catherine Chapelon-Abric, Delphine Maucort-Boulch, Fleur Cohen-Aubart, Laurent Pérard, Laurence Bouillet, Sébastien Abad, Philip Bielefeld, Diane Bouvry, Marc André, Nicolas Noël, Boris Bienvenu, Alice Proux, Sandra Vukusic, Bahram Bodaghi, Françoise Sarrot-Reynaud, Jean Iwaz, Christiane Broussolle, David Saadoun, Yvan Jamilloux, Dominique Valeyre, Pascal Sève, Groupe Sarcoïdose Francophone
• Journal: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG (Sarcoidosis Vasc Diffuse Lung Dis) Vol. 34 Issue 1 Pg. 74-80 ( 2017) ISSN: 2532-179X [Electronic] Italy
• PMID: 32476825 (Publication Type: Journal Article)
• Copyright: Copyright: © 2017.