Biologics in peripheral ulcerative keratitis

Daniel Clarke; Lauren Sartor; Vu Do; Nicholas Manolios; Sanjay Swaminathan; Chameen Samarawickrama

doi:10.1016/j.semarthrit.2023.152269

Biologics in peripheral ulcerative keratitis

Semin Arthritis Rheum. 2023 Dec:63:152269. doi: 10.1016/j.semarthrit.2023.152269. Epub 2023 Sep 26.

Authors

Daniel Clarke¹, Lauren Sartor², Vu Do³, Nicholas Manolios², Sanjay Swaminathan⁴, Chameen Samarawickrama⁵

Affiliations

¹ Department of Ophthalmology, Royal Hobart Hospital, Tasmania, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
² Department of Ophthalmology, Westmead Hospital, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
³ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁴ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Rheumatology, Westmead Hospital, Westmead, Sydney, New South Wales, Australia; Department of Clinical Immunology and Immunopathology, Westmead Hospital, Sydney, New South Wales, Australia; Centre for Immunology and Allergy Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.
⁵ Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Translational Ocular Research and Immunology Consortium, Sydney University, New South Wales, Australia. Electronic address: chameen.sams@sydney.edu.au.

PMID: 37776666
DOI: 10.1016/j.semarthrit.2023.152269

Abstract

Over the past two decades biologic therapies have seen a rapid uptake in the management of ocular inflammation. Peripheral ulcerative keratitis (PUK), once a harbinger of blindness and mortality in refractory rheumatological disease, is now increasingly being treated with these agents. We conducted a review to evaluate the evidence base for this application and to provide a road map for their clinical usage in PUK, including dosage and adverse effects. A literature search across Medline, Embase and Cochrane Database of Systematic Reviews was undertaken to identify all patients with PUK that were treated with a biologic in a peer viewed article. Overall, whilst the evidence base for biologic use in PUK was poor, reported cases demonstrate an increasingly powerful and effective role for biologics in refractory PUK. This was particularly the case for rituximab in PUK secondary to granulomatous with polyangiitis.

Keywords: Biologics; Granulomatous with polyangiitis; Peripheral ulcerative keratitis; Rituximab.

Publication types

Review

MeSH terms

Biological Products* / therapeutic use
Corneal Ulcer* / drug therapy
Humans
Rituximab / therapeutic use
Systematic Reviews as Topic

Substances

Rituximab
Biological Products