Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study
We aimed to assess the efficacy of biologic therapy in refractory non-Multiple Sclerosis (MS) Optic Neuritis (ON), a condition more infrequent, chronic and severe than MS ON. This was an open-label multicenter study of patients with non-MS ON refractory to systemic corticosteroids and at least one c...
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Format: | Article |
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MDPI AG
2020-08-01
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Series: | Journal of Clinical Medicine |
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Online Access: | https://www.mdpi.com/2077-0383/9/8/2608 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alba Herrero-Morant Carmen Álvarez-Reguera José L. Martín-Varillas Vanesa Calvo-Río Alfonso Casado Diana Prieto-Peña Belén Atienza-Mateo Olga Maiz-Alonso Ana Blanco Esther Vicente Íñigo Rúa-Figueroa Laura Cáceres-Martin José L. García-Serrano José Luis Callejas-Rubio Norberto Ortego-Centeno Javier Narváez Susana Romero-Yuste Julio Sánchez Paula Estrada Rosalía Demetrio-Pablo David Martínez-López Santos Castañeda José L. Hernández Miguel Á. González-Gay Ricardo Blanco |
spellingShingle |
Alba Herrero-Morant Carmen Álvarez-Reguera José L. Martín-Varillas Vanesa Calvo-Río Alfonso Casado Diana Prieto-Peña Belén Atienza-Mateo Olga Maiz-Alonso Ana Blanco Esther Vicente Íñigo Rúa-Figueroa Laura Cáceres-Martin José L. García-Serrano José Luis Callejas-Rubio Norberto Ortego-Centeno Javier Narváez Susana Romero-Yuste Julio Sánchez Paula Estrada Rosalía Demetrio-Pablo David Martínez-López Santos Castañeda José L. Hernández Miguel Á. González-Gay Ricardo Blanco Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study Journal of Clinical Medicine optic neuritis biologic therapy rituximab tocilizumab adalimumab infliximab |
author_facet |
Alba Herrero-Morant Carmen Álvarez-Reguera José L. Martín-Varillas Vanesa Calvo-Río Alfonso Casado Diana Prieto-Peña Belén Atienza-Mateo Olga Maiz-Alonso Ana Blanco Esther Vicente Íñigo Rúa-Figueroa Laura Cáceres-Martin José L. García-Serrano José Luis Callejas-Rubio Norberto Ortego-Centeno Javier Narváez Susana Romero-Yuste Julio Sánchez Paula Estrada Rosalía Demetrio-Pablo David Martínez-López Santos Castañeda José L. Hernández Miguel Á. González-Gay Ricardo Blanco |
author_sort |
Alba Herrero-Morant |
title |
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study |
title_short |
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study |
title_full |
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study |
title_fullStr |
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study |
title_full_unstemmed |
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study |
title_sort |
biologic therapy in refractory non-multiple sclerosis optic neuritis isolated or associated to immune-mediated inflammatory diseases. a multicenter study |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-08-01 |
description |
We aimed to assess the efficacy of biologic therapy in refractory non-Multiple Sclerosis (MS) Optic Neuritis (ON), a condition more infrequent, chronic and severe than MS ON. This was an open-label multicenter study of patients with non-MS ON refractory to systemic corticosteroids and at least one conventional immunosuppressive drug. The main outcomes were Best Corrected Visual Acuity (BCVA) and both Macular Thickness (MT) and Retinal Nerve Fiber Layer (RNFL) using Optical Coherence Tomography (OCT). These outcome variables were assessed at baseline, 1 week, and 1, 3, 6 and 12 months after biologic therapy initiation. Remission was defined as the absence of ON symptoms and signs that lasted longer than 24 h, with or without an associated new lesion on magnetic resonance imaging with gadolinium contrast agents for at least 3 months. We studied 19 patients (11 women/8 men; mean age, 34.8 ± 13.9 years). The underlying diseases were Bechet’s disease (<i>n</i> = 5), neuromyelitis optica (<i>n</i> = 3), systemic lupus erythematosus (<i>n</i> = 2), sarcoidosis (<i>n</i> = 1), relapsing polychondritis (<i>n</i> = 1) and anti-neutrophil cytoplasmic antibody -associated vasculitis (<i>n</i> = 1). It was idiopathic in 6 patients. The first biologic agent used in each patient was: adalimumab (<i>n</i> = 6), rituximab (<i>n</i> = 6), infliximab (<i>n</i> = 5) and tocilizumab (<i>n</i> = 2). A second immunosuppressive drug was simultaneously used in 11 patients: methotrexate (<i>n</i> = 11), azathioprine (<i>n</i> = 2), mycophenolate mofetil (<i>n</i> = 1) and hydroxychloroquine (<i>n</i> = 1). Improvement of the main outcomes was observed after 1 year of therapy when compared with baseline data: mean ± SD BCVA (0.8 ± 0.3 LogMAR vs. 0.6 ± 0.3 LogMAR; <i>p</i> = 0.03), mean ± SD RNFL (190.5 ± 175.4 μm vs. 183.4 ± 139.5 μm; <i>p</i> = 0.02), mean ± SD MT (270.7 ± 23.2 μm vs. 369.6 ± 137.4 μm; <i>p</i> = 0.03). Besides, the median (IQR) prednisone-dose was also reduced from 40 (10–61.5) mg/day at baseline to. 2.5 (0–5) mg/day after one year of follow-up; <i>p</i> = 0.001. After a mean ± SD follow-up of 35 months, 15 patients (78.9%) achieved ocular remission, and 2 (10.5%) experienced severe adverse events. Biologic therapy is effective in patients with refractory non-MS ON. |
topic |
optic neuritis biologic therapy rituximab tocilizumab adalimumab infliximab |
url |
https://www.mdpi.com/2077-0383/9/8/2608 |
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doaj-0f74f79fb75c459990fd7cd03c6657ad2020-11-25T03:18:10ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0192608260810.3390/jcm9082608Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter StudyAlba Herrero-Morant0Carmen Álvarez-Reguera1José L. Martín-Varillas2Vanesa Calvo-Río3Alfonso Casado4Diana Prieto-Peña5Belén Atienza-Mateo6Olga Maiz-Alonso7Ana Blanco8Esther Vicente9Íñigo Rúa-Figueroa10Laura Cáceres-Martin11José L. García-Serrano12José Luis Callejas-Rubio13Norberto Ortego-Centeno14Javier Narváez15Susana Romero-Yuste16Julio Sánchez17Paula Estrada18Rosalía Demetrio-Pablo19David Martínez-López20Santos Castañeda21José L. Hernández22Miguel Á. González-Gay23Ricardo Blanco24Rheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Hospital Sierrallana, Barrio Ganzo, s/n, 39300 Torrelavega, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology and Ophtalmology, Hospital de Donostia, Paseo Dr. Begiristain, 117, 20080 Donostia, SpainRheumatology and Ophtalmology, Hospital de Donostia, Paseo Dr. Begiristain, 117, 20080 Donostia, SpainRheumatology, Hospital Universitario de La Princesa, C/Diego de León, 62, 28006 Madrid, SpainRheumatology, Hospital Universitario de Gran Canaria Doctor Negrín, C/Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, SpainRheumatology, Hospital Universitario de Gran Canaria Doctor Negrín, C/Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, SpainInternal Medicine and Ophtalmology, Hospital San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, SpainInternal Medicine and Ophtalmology, Hospital San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, SpainInternal Medicine and Ophtalmology, Hospital San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, SpainRheumatology, Hospital de Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L’Hospitalet de Llobregat, SpainRheumatology, Complejo Hospitalario Universitario de Pontevedra, Loureiro Crespo, 2, 36002 Pontevedra, SpainRheumatology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, SpainRheumatology, Hospital de Sant Joan Despí Moisès Broggi, Carrer de Jacint Verdaguer, 90, 08970 Sant Joan Despí, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Hospital Universitario de La Princesa, C/Diego de León, 62, 28006 Madrid, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainRheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, SpainWe aimed to assess the efficacy of biologic therapy in refractory non-Multiple Sclerosis (MS) Optic Neuritis (ON), a condition more infrequent, chronic and severe than MS ON. This was an open-label multicenter study of patients with non-MS ON refractory to systemic corticosteroids and at least one conventional immunosuppressive drug. The main outcomes were Best Corrected Visual Acuity (BCVA) and both Macular Thickness (MT) and Retinal Nerve Fiber Layer (RNFL) using Optical Coherence Tomography (OCT). These outcome variables were assessed at baseline, 1 week, and 1, 3, 6 and 12 months after biologic therapy initiation. Remission was defined as the absence of ON symptoms and signs that lasted longer than 24 h, with or without an associated new lesion on magnetic resonance imaging with gadolinium contrast agents for at least 3 months. We studied 19 patients (11 women/8 men; mean age, 34.8 ± 13.9 years). The underlying diseases were Bechet’s disease (<i>n</i> = 5), neuromyelitis optica (<i>n</i> = 3), systemic lupus erythematosus (<i>n</i> = 2), sarcoidosis (<i>n</i> = 1), relapsing polychondritis (<i>n</i> = 1) and anti-neutrophil cytoplasmic antibody -associated vasculitis (<i>n</i> = 1). It was idiopathic in 6 patients. The first biologic agent used in each patient was: adalimumab (<i>n</i> = 6), rituximab (<i>n</i> = 6), infliximab (<i>n</i> = 5) and tocilizumab (<i>n</i> = 2). A second immunosuppressive drug was simultaneously used in 11 patients: methotrexate (<i>n</i> = 11), azathioprine (<i>n</i> = 2), mycophenolate mofetil (<i>n</i> = 1) and hydroxychloroquine (<i>n</i> = 1). Improvement of the main outcomes was observed after 1 year of therapy when compared with baseline data: mean ± SD BCVA (0.8 ± 0.3 LogMAR vs. 0.6 ± 0.3 LogMAR; <i>p</i> = 0.03), mean ± SD RNFL (190.5 ± 175.4 μm vs. 183.4 ± 139.5 μm; <i>p</i> = 0.02), mean ± SD MT (270.7 ± 23.2 μm vs. 369.6 ± 137.4 μm; <i>p</i> = 0.03). Besides, the median (IQR) prednisone-dose was also reduced from 40 (10–61.5) mg/day at baseline to. 2.5 (0–5) mg/day after one year of follow-up; <i>p</i> = 0.001. After a mean ± SD follow-up of 35 months, 15 patients (78.9%) achieved ocular remission, and 2 (10.5%) experienced severe adverse events. Biologic therapy is effective in patients with refractory non-MS ON.https://www.mdpi.com/2077-0383/9/8/2608optic neuritisbiologic therapyrituximabtocilizumabadalimumabinfliximab |