Anti-TNF-alpha therapy in patients with refractory uveitis due to Behcet's disease: a 1-year follow-up study of 124 patients

Objective. The aim of this study was to assess the efficacy of anti-TNF-alpha therapy in refractory uveitis due to Behcet's disease (BD). Methods. We performed a multicentre study of 124 patients with BD uveitis refractory to conventional treatment including high-dose corticosteroids and at lea...

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Autores: Calvo-Rio, V, Blanco, R, Sanchez-Burson, J, Mesquida, M, Adan, A, Hernandez, MV, Garfella, MH, Pascual, EV, Martinez-Costa, L, Sellas-Fernandez, A, Coma, MC, Diaz-Llopis, M, Gallego, R, Salom, D, Serrano, JLG, Ortego, N, Herreras, JM, Fonollosa, A, Garcia-Aparicio, AM, Maiz, O, Blanco, A, Torre, I, Fernandez-Espartero, C, Jovani, V, Peiteado-Lopez, D, Pato, E, Cruz, J, Fernandez-Cid, C, Aurrecoechea, E, Garcia, M, Caracuel, MA, Montilla, C, Atanes, A, Hernandez, FF, Insua, S, Gonzalez-Suarez, S, Sanchez-Andrade, A, Gamero, F, Linares, L, Romero-Bueno, F, Garcia, AJ, Almodovar, R, Minguez, E, Cubero, CC, Olive, A, Vazquez, J, Moreno, OR, Jimenez-Zorzo, F, Manero, J, Fernandez, SM, Rueda-Gotor, J, Gonzalez-Gay, MA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p14939
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/14939
Access Level:acceso abierto
Palabra clave:Behcet's disease
uveitis
anti-TNF therapy
Descripción
Sumario:Objective. The aim of this study was to assess the efficacy of anti-TNF-alpha therapy in refractory uveitis due to Behcet's disease (BD). Methods. We performed a multicentre study of 124 patients with BD uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. Patients were treated for at least 12 months with infliximab (IFX) (3-5 mg/kg at 0, 2 and 6 weeks and then every 4-8 weeks) or adalimumab (ADA) (usually 40 mg every 2 weeks). The main outcome measures were degree of anterior and posterior chamber inflammation, visual acuity, macular thickness and immunosuppression load. Results. Sixty-eight men and 56 women (221 affected eyes) were studied. The mean age was 38.6 years (S.D. 10.4). HLA-B51 was positive in 66.1% of patients and uveitis was bilateral in 78.2%. IFX was the first biologic agent in 77 cases (62%) and ADA was first in 47 (38%). In most cases anti-TNF-alpha drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-alpha therapy, anterior chamber and vitreous inflammation was observed in 57% and 64.4% of patients, respectively. In both conditions the damage decreased significantly after 1 year. At baseline, 50 patients (80 eyes) had macular thickening [optical coherence tomography (OCT) >250 mu m] and 35 (49 eyes) had cystoid macular oedema (OCT > 300 mu m) that improved from 420 mm (S.D. 119.5) at baseline to 271 mu m (S.D. 45.6) at month 12 (P < 0.01). The best-corrected visual acuity and the suppression load also showed significant improvement. After 1 year of follow-up, 67.7% of patients were inactive. Biologic therapy was well tolerated in most cases. Conclusion. Anti-TNF-alpha therapy is effective and relatively safe in refractory BD uveitis.

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