RT Journal Article
SR Electronic
T1 Scleritis: A Paradoxical Effect of Etanercept? Etanercept-associated Inflammatory Eye Disease
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.110865
DO 10.3899/jrheum.110865
A1 Cécile Gaujoux-Viala
A1 Cecilia Giampietro
A1 Thomas Gaujoux
A1 Hang-Korng Ea
A1 Clément Prati
A1 Philippe Orcel
A1 Daniel Wendling
A1 Frédéric Lioté
YR 2011
UL http://www.jrheum.org/content/early/2011/12/14/jrheum.110865.abstract
AB Objective To describe 3 cases of scleritis associated with etanercept use for rheumatoid arthritis (RA) and to review the literature related to inflammatory eye diseases associated with the use of etanercept. Methods Three cases of severe scleritis during etanercept therapy were analyzed. A systematic review of the literature in PubMed, Embase, and the Cochrane Library was performed, from 1962 to July 2010. Results Three patients with seropositive RA developed scleritis 7–28 months after initiation of etanercept, for the first time during their long-lasting disease. In all patients the underlying disease had responded well to anti-tumor necrosis factor therapy. Ocular inflammation went into remission after discontinuation of etanercept, and no other relapses were observed. One patient experienced a dechallenge-rechallenge phenomenon (improvement in symptoms following discontinuation of the agent, then reappearance or worsening of symptoms on reexposure to the agent). Forty-two cases of inflammatory eye diseases believed to be associated with the use of etanercept have been reported in the literature: 33 uveitis, 8 scleritis, 1 orbital myositis, concerning 16 patients with RA, 10 with juvenile idiopathic arthritis, 14 with ankylosing spondylitis, and 2 with psoriatic spondyloarthropathy. Dechallenge was performed in 28 patients, leading to resolution of symptoms. Rechallenge was done in 6 cases, with clear exacerbation. Conclusion Ocular inflammation is paradoxically a potential adverse effect of etanercept, even in previously uninvolved eyes.