• Gevokizumab for Treatment of Autoimmune, Non-Necrotizing Anterior Scleritis

    By Lynda Seminara and edited by Richard K. Parrish II, MD

    Journal Highlights

    American Journal of Ophthalmology, December 2016

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    Targeting the various cells and cyto­kines implicated in the pathogenesis of noninfectious non-necrotizing scleritis has proved beneficial for treating this vision-threatening condition. In a small phase 1/2 study, Knickelbein et al. investigated the efficacy of gevokizumab, an anti–interleukin 1ß (IL-1ß) monoclonal antibody, in the treatment of noninfectious anterior scleritis. The drug appeared to be effective and well tolerated in their study.

    Eight patients (9 eyes) with active, noninfectious, non-necrotizing anterior scleritis (scleral inflammatory grade of +1 to +3 in at least 1 eye) were enrolled in this nonrandomized prospective single-arm trial.

    Each patient received a subcutane­ous injection of 60 mg of gevokizumab at baseline and at 4-week intervals for 12 weeks. Complete physical and ocular examinations were performed regularly throughout the study. The primary outcome was defined as reduction of at least 2 steps in the inflammatory grade or reduction to grade 0. Secondary out­comes included changes in visual acuity and intraocular pressure. Patients whose eyes met the primary outcome were eligible for an extension study of up to 52 weeks, during which safety was evaluated at weeks 40 and 52.

    Seven eyes (7 patients) achieved the primary outcome within 2 weeks (median) of the first gevokizumab injection. No definitive change in visual acuity or intraocular pressure was iden­tified, and no serious adverse events were attributed to the study drug.

    In conclusion, these promising results suggest that IL-1ß blockage with gevokizumab is well tolerated and effective for treating active, noninfec­tious anterior scleritis. The authors noted that large randomized trials are warranted to confirm their findings.

    The original article can be found here.