Cohort comparative analysis of antimetabolites and biologic drugs on retinal and choroidal features in Birdshot chorioretinopathy
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Yes
Purpose
To assess the effect of antimetabolites (mycophenolate mofetil, azathioprine) and biologics (adalimumab, infliximab) on retinal and choroidal inflammation in Birdshot chorioretinopathy (BSCR).
Methods
Data on drugs and concerning the vitreous, retina (papillitis, macular edema and vasculitis) and choroid (dark dots) at baseline and after 6 months were retrospectively collected from 60 eyes of 30 patients with BSCR (14 female and 16 male) followed at the Ocular Immunology Unit of Reggio Emilia. Descriptive analyses and logistic regression were performed per eye, considering cluster of paired eyes per patient.
Results
Retinal response is more frequent in eyes treated with biologics (83%) compared to antimetabolites (23%), while choroidal response is more frequent with antimetabolites (96%) than biologics (50%). Biologics strongly decrease the risk of vasculitis by 99% compared to antimetabolites (OR=0.07; 95%CI 0.01-0.79). Vitreitis, papillitis and macular edema persist (16%, 18% and 40% respectively) in patients treated with antimetabolites, while with biologics 100% have a complete remission. Antimetabolites show a higher response rate than biologics on dark dots (OR=11.00;95%CI 1.26-98.75).
Conclusion
Biological agents appear to be more effective in controlling inflammation of the retina, whereas antimetabolites on the choroid. These results highlight the need to explore the potential benefits of administering both drug types in the early stage of treatment.
Conflict of interest
No
1
Last name
DE SIMONE
Initials of first name(s)
L
Department
Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
2
Last name
CECCARELLI
Initials of first name(s)
F
Department
Ophthalmology Unit, Department of Experimental Medicine, University of Rome "Tor Vergata"
City
Rome
Country
Italy
3
Last name
VICENTINI
Initials of first name(s)
M
Department
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
4
Last name
BONVICINI
Initials of first name(s)
L
Department
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
5
Last name
FERRARO
Initials of first name(s)
V
Department
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
City
Milan
Country
Italy
6
Last name
BOLLETTA
Initials of first name(s)
E
Department
Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
7
Last name
GOZZI
Initials of first name(s)
F
Department
Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
8
Last name
GENTILE
Initials of first name(s)
P
Department
Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
9
Last name
CIMINO
Initials of first name(s)
L
Department
Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia
City
Reggio Emilia
Country
Italy
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