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Management of Scleritis with Immunosuppressive Drugs and Biologic Agents

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Book cover Scleritis

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Therapy with systemic immunosuppressive drugs and biologics are the most potent therapies available to treat scleritis and are used in a number of clinical scenarios. The most frequent indication to use systemic immunosuppressive drugs is a corticosteroid-sparing therapy to allow the systemic corticosteroid dose to be reduced to a safe maintenance dose. Systemic immunosuppressive therapy is also used in combination with oral corticosteroids to treat associated systemic disease, most commonly severe vasculitis such as ANCA-associated vasculitis or vasculitic rheumatoid arthritis. In this chapter, the commonly used immunosuppressives in scleritis (the antimetabolites, azathioprine, methotrexate, mycophenolate mofetil; the T-cell inhibitors, cyclosporine, tacrolimus; and the alkylating agents, cyclophosphamide, chlorambucil) and biologic agents (TNF-α inhibitors, etanercept, infliximab, adalimumab; the IL-1 receptor antagonist, anakinra; the IL-2 receptor antagonist, daclizumab; and the anti-CD20/B-cell antibody, rituximab) will be discussed.

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Authors and Affiliations

  1. Save Sight Institute, Sydney Medical School, University of Sydney and Sydney Eye Hospital, Sydney, NSW, Australia

    Aaron Yeung PhD, FRCOphth, Sophia L. Zagora FRANZCO & Peter J. McCluskey MD, FRANZCO

  2. Moorfields Eye Hospital, London, UK

    Sophia L. Zagora FRANZCO

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  1. Aaron Yeung PhD, FRCOphth
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  2. Sophia L. Zagora FRANZCO
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  3. Peter J. McCluskey MD, FRANZCO
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Correspondence to Peter J. McCluskey MD, FRANZCO .

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  1. Moorfields Eyes Hospital, London, United Kingdom

    Carlos Pavesio

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Yeung, A., Zagora, S.L., McCluskey, P.J. (2017). Management of Scleritis with Immunosuppressive Drugs and Biologic Agents. In: Pavesio, C. (eds) Scleritis. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-49915-4_9

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  • DOI: https://doi.org/10.1007/978-3-319-49915-4_9

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