{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:48:41Z","timestamp":1787017721730,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T00:00:00Z","timestamp":1579219200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2020,1,17]]},"abstract":"\n Objective<\/jats:italic>\n . To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-)\n \u03b1<\/jats:italic>\n inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders.\n Patients and Methods<\/jats:italic>\n . This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile.\n Results<\/jats:italic>\n . Fourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (\n \n p<\/mml:mi>\n =<\/mml:mo>\n 0.002<\/mml:mn>\n <\/mml:math>\n ) and from baseline to the last follow-up visit (\n \n p<\/mml:mi>\n =<\/mml:mo>\n 0.002<\/mml:mn>\n <\/mml:math>\n ). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (\n \n p<\/mml:mi>\n =<\/mml:mo>\n 0.007<\/mml:mn>\n <\/mml:math>\n ). No differences regarding BCVA were observed (\n \n p<\/mml:mi>\n =<\/mml:mo>\n 0.67<\/mml:mn>\n <\/mml:math>\n ). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment.\n Conclusions<\/jats:italic>\n . Our results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.\n <\/jats:p>","DOI":"10.1155\/2020\/8294560","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T18:34:09Z","timestamp":1579286049000},"page":"1-6","source":"Crossref","is-referenced-by-count":31,"title":["New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-7741","authenticated-orcid":true,"given":"Claudia","family":"Fabiani","sequence":"first","affiliation":[{"name":"Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7549-2922","authenticated-orcid":true,"given":"Jurgen","family":"Sota","sequence":"additional","affiliation":[{"name":"Research Center of Systemic Autoinflammatory Diseases and Beh\u00e7et\u2019s Disease, Rheumatology Unit of the Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8685-766X","authenticated-orcid":true,"given":"Maite","family":"Sainz-de-la-Maza","sequence":"additional","affiliation":[{"name":"Clinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pelegr\u00edn","sequence":"additional","affiliation":[{"name":"Clinical Institute of Ophthalmology, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9575-8321","authenticated-orcid":true,"given":"Giacomo","family":"Emmi","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4524-9566","authenticated-orcid":true,"given":"Giuseppe","family":"Lopalco","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florenzo","family":"Iannone","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Vannozzi","sequence":"additional","affiliation":[{"name":"Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Guerriero","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otolaryngology, University of Bari, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Gelmi","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-7779","authenticated-orcid":true,"given":"Donato","family":"Rigante","sequence":"additional","affiliation":[{"name":"Institute of Pediatrics, Universit\u00e0 Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. 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