Use of infliximab in the treatment of peripheral ulcerative keratitis in Crohn disease.

Abstract

PURPOSE:

To report the effectiveness of infliximab in the treatment of peripheral ulcerative keratitis (PUK) associated with Crohn disease.

DESIGN:

Retrospective, interventional case series.

METHODS:

SETTING:

Institutional, academic referral setting. patient or study population: Six eyes of 3 patients with PUK associated with Crohn disease that failed or were intolerant to traditional immunosuppression such as oral prednisone and cyclophosphamide. INTERVENTION OR OBSERVATION PROCEDURE(S): Infliximab intravenous infusion 5 mg/kg every 2 to 8 weeks.

MAIN OUTCOME MEASURE(S):

Subjective outcome such as pain improvement and objective outcomes such as visual acuity, signs of inflammation, and progression of corneal thinning.

RESULTS:

Symptom of pain improved in all patients. Visual acuity remained stable in 4 of 6 eyes, improved in 1 of 6 eyes, and worsened in 1 of 6 eyes (secondary to stromal scar). Rapid resolution of inflammation and arrest of further thinning were observed in all 6 eyes. Similar effects were observed on recurrence treated with repeat dosing of infliximab in 5 of 6 eyes.

CONCLUSIONS:

Infliximab produced a rapid, dramatic, repeatable suppression of corneal inflammation, pain, and keratolysis in PUK associated with Crohn disease. Although the effect of long-term therapy with these agents is unknown, infliximab should be considered in patients with Crohn-associated PUK not amenable to traditional therapy. Larger prospective studies are needed to determine the efficacy of infliximab in this aggressive disease entity.

• Authors: Mary Pham, Clement C Chow, David Badawi, Elmer Y Tu
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 152 Issue 2 Pg. 183-188.e2 (Aug 2011) ISSN: 1879-1891 [Electronic] United States
• PMID: 21652024 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Infliximab

Topics

• Adult
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Antibodies, Monoclonal (administration & dosage, therapeutic use)
• Corneal Ulcer (drug therapy, physiopathology)
• Crohn Disease (drug therapy, physiopathology)
• Female
• Humans
• Infliximab
• Infusions, Intravenous
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)