Clinical study on efficacy of infliximab on severity and occurrence of acute anterior uveitis in HLA-B27

Abstract

Aim: To study the efficacy of Infliximab on the severity and occurrence of Acute Anterior Uveitis in HLA B27 positive patients. Materials and Methods: This is a prospective observational study done on 30 patients with acute anterior uveitis who were HLA B27 positive presenting to Uvea and Retina Services at Regional Institute of Ophthalmology Government Ophthalmic Hospital, Chennai between April 2013 to May 2015. Of which 16 patients were on Infliximab therapy (3-5mg/kg) for Ankylosing Spondylitis, 6 patients were on Tablet Sulfasalazine for the articular symptoms of Ankylosing Spondylitis and 8 patients were not on any medication and were retrospectively diagnosed as HLA-B27 positive. A detailed history, systemic examination, ocular examination using Slit lamp, 90D biomicroscopy, blood investigations for HLA B27 and MRI Sacroiliac joint was done. Patients were started on topical corticosteroids and cycloplegics, the response noted and followed up for 3 months. Results: Severity of uveitis did not show any variation between groups that were on infliximab and sulfasalazine and those who were not on any treatment. Patients in the three groups responded dramatically well to topical corticosteroids and cycloplegics. Conclusion: Infliximab (3-5mg/kg) regime used for the control of symptoms of Ankylosing Spondylitis neither prevents the occurrence nor decreases the severity of Acute Anterior Uveitis in HLA-B27 patients. Further studies are needed to establish the safe and effective dosage of Infliximab to prevent the occurrences of Acute Anterior Uveitis in HLA B27 patients.