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Efficacy and safety of intravitreal anti-tumour necrosis factor drugs in adults with non-infectious uveitis : a systematic review

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dc.contributor.authorLeal, Ines
dc.contributor.authorRodrigues, Filipe Brogueira
dc.contributor.authorSousa, David Cordeiro
dc.contributor.authorRomão, Vasco C.
dc.contributor.authorDuarte, Gonçalo Silva
dc.contributor.authorCarreño, Ester
dc.contributor.authorDick, Andrew D.
dc.contributor.authorMarques-Neves, Carlos
dc.contributor.authorCosta, João
dc.contributor.authorFonseca, João Eurico
dc.date.accessioned2018-04-30T18:02:03Z
dc.date.available2018-04-30T18:02:03Z
dc.date.issued2018
dc.description© 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.pt_PT
dc.description.abstractAnti-tumour necrosis factor (TNF) drugs have been extensively used in non-infectious uveitis (NIU), when corticosteroids or conventional immunosuppressive drugs cannot adequately control inflammation or intolerable side-effects occur. However, systemic anti-TNF therapies are also associated with a myriad of side-effects. Therefore, intravitreal administration of anti-TNF biologics has been employed to minimize patient morbidity and systemic adverse effects, while maintaining therapeutic effectivity. We undertook a systematic review to determine evidence of efficacy and safety of intravitreal administration of anti-TNF drugs in adults with NIU. We conducted this systematic review according to the PRISMA guidelines. The protocol was registered with PROSPERO (CRD42016041946). We searched CENTRAL, MEDLINE and EMBASE, from inception to April 2017, as well as clinical trial registries and grey literature. The qualitative analysis included all studies of adult patients with a diagnosis of NIU and who received intravitreal anti-TNF drugs with a 4-week minimum follow-up. A total of 4840 references were considered for title and abstract screening. Seven full texts were screened, and five studies were considered for analysis. All studies were open-label, single-centre, prospective, non-randomized, interventional case series with a follow-up between 4 and 26 weeks, employing either adalimumab in two studies and infliximab in three. Three studies showed a treatment effect of anti-TNF intravitreal injections, while one study revealed short-term improvement and one study revealed no efficacy of anti-TNF intravitreal therapy. None of the studies reported ocular adverse effects but only two studies included electrophysiological assessment in the safety analysis and no study assessed systemic human anti-drug antibodies. The available evidence is not sufficiently robust to conclude about the clinical effectivity of intravitreal anti-TNF in NIU and so no recommendation can be made. In conclusion, intravitreal injection of anti-TNF antibodies remains a possible treatment option to be explored through robust clinical investigation.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Ophthalmol. 2018 Mar 25pt_PT
dc.identifier.doi10.1111/aos.13699pt_PT
dc.identifier.issn1755-375X
dc.identifier.urihttp://hdl.handle.net/10451/33065
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherJohn Wiley & Sons Ltdpt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/17553768pt_PT
dc.subjectAnti-tumour necrosis factorpt_PT
dc.subjectBiologicspt_PT
dc.subjectIntravitrealpt_PT
dc.subjectNon-infectious uveitispt_PT
dc.titleEfficacy and safety of intravitreal anti-tumour necrosis factor drugs in adults with non-infectious uveitis : a systematic reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleActa Ophthalmologicapt_PT
person.familyNameLeal
person.familyNameRodrigues
person.familyNameSousa
person.familyNameC Romão
person.familyNameDuarte
person.familyNameMarques Neves
person.familyNameCosta
person.familyNameFonseca
person.givenNameInes
person.givenNameFilipe Brogueira
person.givenNameDavid Cordeiro
person.givenNameVasco
person.givenNameGonçalo
person.givenNameCarlos
person.givenNameJoão
person.givenNameJoão
person.identifier707480
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person.identifier.orcid0000-0002-3842-2466
person.identifier.orcid0000-0002-5831-4921
person.identifier.orcid0000-0003-1432-3671
person.identifier.ridR-2679-2017
person.identifier.ridA-6192-2015
person.identifier.ridO-8224-2014
person.identifier.ridL-4920-2015
person.identifier.scopus-author-id57187966600
person.identifier.scopus-author-id57191254295
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rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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