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Cao H, Ma X. Rituximab in the Treatment of Non-Infectious Uveitis: A Review. J Inflamm Res 2024; 17:6765-6780. [PMID: 39364118 PMCID: PMC11448468 DOI: 10.2147/jir.s477708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 09/21/2024] [Indexed: 10/05/2024] Open
Abstract
Non-infectious uveitis (NIU) is an immune-mediated disorder manifesting as ocular pain, redness, floaters, and photophobia, and is a leading cause of preventable blindness. Managing NIU presents considerable challenges due to the condition's resistance to high-dose corticosteroids and various immunotherapies. This review assesses the efficacy and safety of rituximab (RTX) in the treatment of NIU, based on individual case reports and small-scale studies. A cohort of 78 patients (20 males, 58 females), with a mean onset age of 32.3 years (range 8-72), was analyzed. Juvenile idiopathic arthritis (JIA) was the most frequently associated comorbidity, affecting 28 patients, while anterior uveitis was the predominant subtype, observed in 26 of 47 cases. Prior to RTX therapy, patients had been treated with an average of 1.7 conventional immunosuppressive agents (range 0-5) and 1.1 biologics (range 0-4). RTX was introduced following the failure of high-dose corticosteroids, immunosuppressive drugs, and biologics to control the uveitis. The median time from diagnosis to RTX initiation was 7.7 years (range 0.25-21). Post-RTX, 44.2% of patients experienced improvement in visual acuity, 79.5% achieved resolution of ocular inflammation, and 8.9% showed partial improvement. Additionally, 81.1% were able to reduce their corticosteroid dosage. Overall, 88.6% (69 out of 78) demonstrated a positive response to RTX treatment. These findings indicate that RTX may serve as an effective therapeutic option for NIU unresponsive to steroids and multiple immunotherapies. It may also warrant consideration as a potential first-line treatment in certain cases.
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Affiliation(s)
- Haixing Cao
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, People’s Republic of China
| | - Xiang Ma
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, People’s Republic of China
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Meng T, Zheng J, Chen M, Zhao Y, Sudarjat H, M.R. AA, Kulkarni V, Oh Y, Xia S, Ding Z, Han H, Anders N, Rudek MA, Chow W, Stark W, Ensign LM, Hanes J, Xu Q. Six-month effective treatment of corneal graft rejection. SCIENCE ADVANCES 2023; 9:eadf4608. [PMID: 36947612 PMCID: PMC10032610 DOI: 10.1126/sciadv.adf4608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Topical corticosteroid eye drop is the mainstay for preventing and treating corneal graft rejection. While the frequent topical corticosteroid use is associated with risk of intraocular pressure (IOP) elevation and poor patient compliance that leads to graft failure and the requirement for a repeated, high-risk corneal transplantation. Here, we developed dexamethasone sodium phosphate (DSP)-loaded dicarboxyl-terminated poly(lactic acid) nanoparticle (PLA DSP-NP) formulations with relatively high drug loading (8 to 10 weight %) and 6 months of sustained intraocular DSP delivery in rats with a single dosing. PLA DSP-NP successfully reversed early signs of corneal rejection, leading to rat corneal graft survival for at least 6 months. Efficacious PLA DSP-NP doses did not affect IOP and showed no signs of ocular toxicity in rats for up to 6 months. Subconjunctival injection of DSP-NP is a promising approach for safely preventing and treating corneal graft rejection with the potential for improved patient adherence.
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Affiliation(s)
- Tuo Meng
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Jinhua Zheng
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China
| | - Min Chen
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong 266073, China
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Yang Zhao
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hadi Sudarjat
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Aji Alex M.R.
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Vineet Kulkarni
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Yumin Oh
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Shiyu Xia
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Zheng Ding
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Hyounkoo Han
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Nicole Anders
- Department of Medicine, The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Michelle A. Rudek
- Department of Medicine, The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Woon Chow
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Walter Stark
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Laura M. Ensign
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Justin Hanes
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
- Center for Nanomedicine, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Qingguo Xu
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA
- Center for Pharmaceutical Engineering and Institute for Structural Biology, Drug Discovery and Development (ISB3D), Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA
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Aboalazayem F, Elhusseiny AM, El Sayed YM. Gonioscopy-Assisted Transluminal Trabeculotomy; A Review. Curr Eye Res 2022; 48:329-338. [PMID: 35634789 DOI: 10.1080/02713683.2022.2084113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To review the recent evidence in the literature regarding the efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in the management of pediatric and adult glaucoma. METHODS A literature search was performed in the electronic databases of PubMed, Google Scholar, Embase the Register of Controlled Trials, and Ovid Medline for studies evaluating the safety and outcomes of GATT in glaucoma. RESULTS GATT is a novel minimally invasive glaucoma surgery that allows the incision of the inner wall of Schlemm's canal increasing aqueous drainage through the physiologic outflow pathway with subsequent intraocular pressure reduction in different types if of glaucoma. CONCLUSION GATT demonstrated favorable results in a wide range of both primary and secondary open-angle and angle-closure glaucoma.
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Affiliation(s)
- Fayrouz Aboalazayem
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
| | - Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yasmine M. El Sayed
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
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