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© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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 (n = 5), neuromyelitis optica (n = 3), systemic lupus erythematosus (n = 2), sarcoidosis (n = 1), relapsing polychondritis (n = 1) and anti-neutrophil cytoplasmic antibody -associated vasculitis (n = 1). It was idiopathic in 6 patients. The first biologic agent used in each patient was: adalimumab (n = 6), rituximab (n = 6), infliximab (n = 5) and tocilizumab (n = 2). A second immunosuppressive drug was simultaneously used in 11 patients: methotrexate (n = 11), azathioprine (n = 2), mycophenolate mofetil (n = 1) and hydroxychloroquine (n = 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; p = 0.03), mean ± SD RNFL (190.5 ± 175.4 μm vs. 183.4 ± 139.5 μm; p = 0.02), mean ± SD MT (270.7 ± 23.2 μm vs. 369.6 ± 137.4 μm; p = 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; p = 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.

Details

Title
Biologic Therapy in Refractory Non-Multiple Sclerosis Optic Neuritis Isolated or Associated to Immune-Mediated Inflammatory Diseases. A Multicenter Study
Author
Herrero-Morant, Alba 1 ; Álvarez-Reguera, Carmen 1 ; Martín-Varillas, José L 2 ; Calvo-Río, Vanesa 1 ; Casado, Alfonso 1 ; Prieto-Peña, Diana 1 ; Atienza-Mateo, Belén 1 ; Maiz-Alonso, Olga 3 ; Blanco, Ana 3 ; Vicente, Esther 4 ; Rúa-Figueroa, Íñigo 5   VIAFID ORCID Logo  ; Cáceres-Martin, Laura 5 ; García-Serrano, José L 6 ; Callejas-Rubio, José Luis 6 ; Ortego-Centeno, Norberto 6 ; Narváez, Javier 7   VIAFID ORCID Logo  ; Romero-Yuste, Susana 8 ; Sánchez, Julio 9 ; Estrada, Paula 10   VIAFID ORCID Logo  ; Demetrio-Pablo, Rosalía 1 ; Martínez-López, David 1 ; Castañeda, Santos 4 ; Hernández, José L 1   VIAFID ORCID Logo  ; González-Gay, Miguel Á 1   VIAFID ORCID Logo  ; Blanco, Ricardo 1   VIAFID ORCID Logo 

 Rheumatology, Ophtalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, Av. de Valdecilla, 25, 39008 Santander, Spain; [email protected] (A.H.-M.); [email protected] (C.Á.-R.); [email protected] (V.C.-R.); [email protected] (A.C.); [email protected] (D.P.-P.); [email protected] (B.A.-M.); [email protected] (R.D.-P.); [email protected] (D.M.-L.) 
 Rheumatology, Hospital Sierrallana, Barrio Ganzo, s/n, 39300 Torrelavega, Spain; [email protected] 
 Rheumatology and Ophtalmology, Hospital de Donostia, Paseo Dr. Begiristain, 117, 20080 Donostia, Spain; [email protected] (O.M.-A.); [email protected] (A.B.) 
 Rheumatology, Hospital Universitario de La Princesa, C/Diego de León, 62, 28006 Madrid, Spain; [email protected] (E.V.); [email protected] (S.C.) 
 Rheumatology, Hospital Universitario de Gran Canaria Doctor Negrín, C/Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Spain; [email protected] (Í.R.-F.); [email protected] (L.C.-M.) 
 Internal Medicine and Ophtalmology, Hospital San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, Spain; [email protected] (J.L.G.-S.); [email protected] (J.L.C.-R.); [email protected] (N.O.-C.) 
 Rheumatology, Hospital de Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L’Hospitalet de Llobregat, Spain; [email protected] 
 Rheumatology, Complejo Hospitalario Universitario de Pontevedra, Loureiro Crespo, 2, 36002 Pontevedra, Spain; [email protected] 
 Rheumatology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, Spain; [email protected] 
10  Rheumatology, Hospital de Sant Joan Despí Moisès Broggi, Carrer de Jacint Verdaguer, 90, 08970 Sant Joan Despí, Spain; [email protected] 
First page
2608
Publication year
2020
Publication date
2020
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2641055088
Copyright
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.