Subcutaneous repository corticotropin gel for non-infectious panuveitis: Reappraisal of an old pharmacologic agent

Aniruddha Agarwal, Muhammad Hassan, Yasir J. Sepah, Diana V. Do, Quan Dong Nguyen

Research output: Contribution to journalArticle

Abstract

Purpose To describe the clinical course of a patient with non-infectious idiopathic unilateral panuveitis and retinal vasculitis treated with subcutaneous repository adrenocorticotropic hormone (ACTH) gel. Observations A 33-year-old male presented with blurry vision and floaters in the left eye (OS). The best-corrected visual acuity was 20/20 in the right eye (OD) and 20/50 in OS at the time of initial presentation. Slit-lamp examination revealed mild anterior segment inflammation in OS. There were 1 + vitreous haze and 2 + cells noted in OS. Clinical examination and ancillary imaging assessment including fluorescein angiography revealed retinal vasculitis and optic nerve head inflammation. After infectious etiologies were ruled out, the patient was started on oral corticosteroids and enrolled in a clinical trial employing intravenous tocilizumab therapy. Six months after completion of the tocilizumab trial, the patient demonstrated recurrence of disease. Twice weekly subcutaneous ACTH gel was initiated and the patient demonstrated improvement of retinal vascular inflammation. Conclusions and importance Repository subcutaneous ACTH gel formulation may be a safe and viable therapeutic option for patients with non-infectious uveitis and retinal vasculitis. Clinical trials using this formulation in a larger patient cohort with longer monitoring are indicated to evaluate its tolerability and bioactivity.

Original languageEnglish (US)
Pages (from-to)78-82
Number of pages5
JournalAmerican Journal of Ophthalmology Case Reports
Volume4
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Fingerprint

Panuveitis
Adrenocorticotropic Hormone
Gels
Retinal Vasculitis
Inflammation
Clinical Trials
losigame
Retinal Vessels
Fluorescein Angiography
Optic Disk
Uveitis
Visual Acuity
Adrenal Cortex Hormones
Recurrence
Therapeutics

Keywords

  • ACTH
  • Melanocortins
  • Non-infectious uveitis
  • Panuveitis
  • Retinal vasculitis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Subcutaneous repository corticotropin gel for non-infectious panuveitis : Reappraisal of an old pharmacologic agent. / Agarwal, Aniruddha; Hassan, Muhammad; Sepah, Yasir J.; Do, Diana V.; Nguyen, Quan Dong.

In: American Journal of Ophthalmology Case Reports, Vol. 4, 01.12.2016, p. 78-82.

Research output: Contribution to journalArticle

Agarwal, Aniruddha ; Hassan, Muhammad ; Sepah, Yasir J. ; Do, Diana V. ; Nguyen, Quan Dong. / Subcutaneous repository corticotropin gel for non-infectious panuveitis : Reappraisal of an old pharmacologic agent. In: American Journal of Ophthalmology Case Reports. 2016 ; Vol. 4. pp. 78-82.
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