In analyzing a case series of patients with noninfectious uveitis who were treated with sustained-release corticotropin, which has immune-modulatory and anti-inflammatory effects researchers found that concomitant medication use and dosages were reduced. Among patients on this regimen, 84% improved, 16% stayed the same and none worsened; in addition, 86% of patients had improvement in vision.
The drug was delivered in a form known as a repository corticotropin injection (RCI), injected intramuscularly or subcutaneously. RCI stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone and various androgenic substances.
The study included 91 patients with mean age of 41. Most patients had moderate (n =48) to severe (n=21) visual impairment and none were blind before RCI therapy. Patients had been diagnosed with uveitis for an average of four years and had used two to three other prior medications, which often included 10mg/day or higher doses of corticosteroids for six months or longer. After RCI therapy, many patients discontinued or reduced their dose of concomitant uveitis medications across all drug classes—oral, intraocular and topical steroids, nonsteroidal topical ophthalmic agents and biologics.
The study noted patients reported improvements in vision, pain and vitreous haze, (86%, 27% and 26%, respectively). Researchers noticed no two patients in the study received the same RCI regimen. Similar proportions of patients across different RCI regimens improved, suggesting physicians are tailoring RCI dosing regimens based on each patient's specific case. The study concluded that its findings support the use of RCI as a treatment option for uveitis and also provide a better understanding of practice patterns that may contribute to its appropriate use.
|1. Nelson WW, Lima AF, Kranyak J, et al. Retrospective medical record review to describe use of repository corticotropin injection among patients with uveitis in the United States. J Ocul Pharmocol Ther. 2019;35(3):182-88.