Efficacy of Anti-TNF-α Therapy for the Treatment of Non-infectious Uveitis: A Retrospective Study of 21 Patients PDF Download

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Languages : en
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Author: Elisabetta Miserocchi
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805599862
Category : Medical
Languages : en
Pages : 179

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Book Description
Uveitis is a potentially blinding inflammatory disease that presents one of the most serious and complicated therapeutic challenges in the field of ophthalmology. During the last decade, the therapeutic armamentarium of the uveitis specialist has enormously expanded. Novel biologic agents and intraocular therapy are becoming a valuable alternative treatment to control ocular inflammatory diseases and inflammatory macular edema -- the most important cause of visual loss in patients with uveitis. This publication is designed to bring together the principles of therapy of patients with noninfectious uveitis and the most recent therapeutic options available. General ophthalmologists, uveitis specialists as well as residents will find it a useful update on the latest innovative treatment options for patients with noninfectious uveitis.

Author: Phoebe Lin
Publisher: Springer Nature
ISBN: 3030228274
Category : Medical
Languages : en
Pages : 205

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This unique, comprehensive book provides a much-needed reference on the treatment and management of non-infectious uveitis. Carefully designed, Treatment of Non-infectious Uveitis is the first book of its kind to provide an in-depth, clinically-relevant, expert-driven resource for ophthalmologists focusing on modalities of uveitis treatment, their mechanism of action, dosing, and side effects. Each chapter provides an introduction, mechanism of action, indication, dosage, side effects, and efficacy summaries from clinical trials and other published literature. Topics range from topical treatment, to locally administered therapy including drug-releasing implants, to systemic immunosuppressive treatments both tried and new, as well as surgical management, with each chapter highlighting important practice pearls as well as easy-reference dosing tables, side effects, and lab monitoring pertinent to the agents discussed. The book concludes with a discussion of novel approaches to the treatment of non-infectious uveitis, and special considerations when treating uveitis in the pediatric patient. The majority of patients with non-infectious uveitis are treated by comprehensive ophthalmologists, many of whom are less familiar with established treatment guidelines outlining the role of corticosteroids and immunomodulatory therapy. While the non-specialist, resident, or fellow is sure to benefit from this one-stop guide to uveitis treatment, retina and uveitis specialists alike will also appreciate the practice tips and thorough coverage of this expertly-written reference. Treatment of Non-infectious Uveitis is the ideal reference for all ophthalmologists who seek to improve their understanding of the causes of uveitis and learn how to best treat this condition.

Author: Frederick T. Fraunfelder
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 578

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Author: C. Stephen Foster
Publisher:
ISBN: 9781733237611
Category :
Languages : en
Pages :

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The purpose of this book is to provide a concise but precise consensus on the impact of uveitis in children and on the diagnostic and therapeutic approaches. Experts in Ocular Immunology and Rheumatology were convened in an effort to provide guidelines in the diagnosis and treatment of uveitis in children. The result of those efforts are captured in this monograph.

Author: Jyotirmay Biswas
Publisher: Springer
ISBN: 8132222954
Category : Medical
Languages : en
Pages : 180

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This book on recent advances in uveitis provides readers with up-to-date and clinically-relevant information on 18 topics that are indispensable for everyday practice. This book is meant for bridging the gap between recent developments and their incorporation into clinical use. Written by global experts, the topics cover advances in diagnosis and treatment of distinct clinical varieties of uveitis. Additionally, the chapter on imaging describes the various imaging modalities that aid clinching the diagnosis with greater accuracy. Role of corticosteroids, their mechanism of action and various routes of drug delivery too have been discussed in detail. Optimal use of various immunomodulators, their role, dose, mechanism of action, side effects, and monitoring during patient follow-up have been elucidated in easy-to-understand tables. There are two chapters on complications in uveitis, one on glaucoma and other on choroidal neovascularization. A chapter on pediatric uveitis highlights the challenges and provides guidance to manage this special population.

Author: Ahmed Talib Kasb Al-Janabi
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Uveitis is a significant cause of visual morbidity in the working-age population and has a high propensity to recur and cause damage to the ocular tissues which compromise the patient's sight and that can be irreversible. This dissertation addresses the question of how different treatment regimens influence disease recurrence, improve visual outcome and reduce the dose of concomitant immunosuppressive therapy in patients with sight-threatening ocular inflammatory conditions. Therapeutic agents targeting specific inflammatory mediators are playing an increasingly important role in the management of non-infectious uveitis. The first study examined the role of anti-TNFα drugs and rituximab (anti-CD20) in controlling ocular inflammation in 82 patients with non-infectious, intermediate posterior and panuveitis refractory to conventional immunosuppression. Treatment with these agents achieved better disease control manifested by significant reduction in concomitant immunosuppressive therapy, substantial decrease in disease relapse rate and stability in visual acuity. Both adalimumab and infliximab have similar efficacy and corticosteroids sparing effect; however, compared to infliximab, adalimumab was better tolerated and was associated with significantly lower drug discontinuation rate (treatment failure). Behcet's patients on TNFα blockers had 75% risk reduction in disease recurrence compared non-Behcet's disease subjects which point to the central role of TNFα in Behcet disease pathogenesis. Finally, treatment with TNFα inhibitors and rituximab was effective for extended follow-up periods (5 years and beyond). Statins used to reduce serum cholesterol and improve cardiovascular outcomes in high-risk patients was shown to have pleiotropic anti-inflammatory effects in several in-vivo and in vitro studies. The second study is a phase II, randomised, placebo-controlled trial, examined the effect of simvastatin (80 mg per day) on the amount of concomitant immunosuppressive drugs in 32 patients with non-infectious intermediate, posterior, and panuveitis, at one and two years follow-up visits. Analysing the mean prednisolone dose did not show a significant difference between the two groups. Therefore, there is no evidence to support the anti-inflammatory effect of simvastatin in uveitis. However, given the long-term exposure to corticosteroid-based immunosuppressive therapy, these patients were found to have high serum cholesterol. Our data shows that intensive lipid lowering with simvastatin significantly decreased total cholesterol and LDL and thus reducing the risk of atherosclerotic cardiovascular diseases. Ocular toxoplasmosis, the most common cause of infectious posterior uveitis, has drastic consequences on vision if it involves vision-sensitive structures. The third study looked retrospectively at the role of co-trimoxazole as a prophylactic agent in patients with recurrent sight-threatening disease. Prophylaxis course with co-trimoxazole treatment resulted in a substantial reduction in disease recurrence and significant improvement in vision in comparison to controls. To our knowledge, this is the first study to report improvement in visual acuity on prophylactic therapy, in a disease where no therapy, over the past two decades, was reported to achieve an increase in vision.

Author: Yusuf Yazici
Publisher: Springer Nature
ISBN: 3030241319
Category : Medical
Languages : en
Pages : 328

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The expanded second edition of this important work provides an up-to-date and comprehensive overview of Behçet syndrome. New and updated chapters focus on recent advances in the areas of pathogenesis, the microbiome, genetics and epigenetics, clustering of symptoms, disease assessment and new treatment options. The book examines how these developments have changed the way physicians approach diagnosis, treatment, and management of Behçet patients. It also analyzes the wide variety of clinical manifestations of the disease including mucocutaneous lesions, intraocular inflammation, central nervous system involvement, deep vein thrombosis and other forms of major vascular disease. Building on the success of its predecessor, the Second Edition of Behçet Syndrome is an invaluable resource for physicians, residents, fellows, and graduate students in rheumatology, dermatology, ophthalmology, neurology, gastroenterology, and internal medicine.

Author: Gonzalo E. Yevenes
Publisher: Frontiers Media SA
ISBN: 2889663981
Category : Science
Languages : en
Pages : 377

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Author: Jashin J. Wu
Publisher: Elsevier Health Sciences
ISBN: 0323447988
Category : Medical
Languages : en
Pages : 352

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A brand-new title in the field of dermatology, Therapy for Severe Psoriasis provides the ultimate coverage of the treatment options available for today's most serious cases, including biologics and oral therapies. It features discussions of the newest drug therapies, recent FDA-approved biosimilars, and combination approaches to care, while an overview chapter was designed to aid those new to the field in understanding the nuances of difficult-to-treat subtypes of psoriasis. Comprehensive and focused, Therapy for Severe Psoriasis will be a welcome addition to the library of any dermatologist seeking in-depth information on the challenges of this condition. Each of the 16 chapters includes either an in-depth focus on a single therapy or an overview of a unique aspect of psoriasis, including: UVB therapy, methotrexate, acitretin, cyclosporine, apremilast, etanercept, infliximab, adalimumab, ustekinumab, secukinumab, and ixekizumab. Takes an evidence-based approach to hard-to-treat severe psoriasis. Discusses the newest drug therapies (such as ixekizumab), plus recent FDA-approved biosimilars, a topic unique to this particular psoriasis text. Presents combination approaches for instances when standard treatments are not successful. Includes an overview chapter to help beginners understand the nuances of the disorder.