Therapeutic Outcomes of Non-Infectious Scleritis Treated with Tumor Necrosis Factor-Alpha Inhibitors

Purpose: We determine the efficacy of tumor necrosis factor-alpha (TNF) inhibitors in establishing scleritis quiescence. Methods: We conducted a multicenter retrospective chart review of patients with non-infectious scleritis treated with a TNF inhibitor for at least 6 months. The primary endpoint was scleritis quiescence at 6 months. Secondary endpoints included scleritis quiescence at 12 months, TNF inhibitor effects on concurrent doses of systemic corticosteroids and visual acuity outcomes at 6 and 12 months. Results: At 6 months, 82.2% (37/45) of subjects obtained scleritis quiescence with TNF inhibition. At 12 months, 76.2% (32/42) of subjects remained quiescent. Baseline daily corticosteroid use (21.5 +/- 21.6 mg) decreased to 5.4 +/- 8.3 mg by 6 months (p < 0.0001) and 2.8 +/- 6.1 mg by 12 months (p < 0.001). There was no significant difference between the baseline and 6-month BCVA (p = 0.52). Conclusions: TNF inhibitors are an effective scleritis therapy with significant systemic corticosteroid sparing effect.