The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behcet's disease: results of a multicentre open-label study

Objective. To assess the efficacy of other biologic therapies, different from IFX and ADA, in patients with Behvet's disease uveitis (BU). Methods. Multicentre study of 124 patients with BU refractory to at least one standard immunosuppressive agent that required IFX or ADA therapy. Patients wh...

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Detalles Bibliográficos
Autores: Santos-Gómez M, Calvo-Río V, Blanco R, Beltrán E, Mesquida M, Adán A, Cordero-Coma M, García-Aparicio ÁM, Valls Pascual E, Martínez-Costa L, Hernández MV, Hernandez Garfella M, González-Vela MC, Pina T, Palmou-Fontana N, Loricera J, Hernández JL, González-Gay MA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p11009
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/11009
Access Level:acceso abierto
Palabra clave:uveitis
Behcet's disease
biologic therapy
Descripción
Sumario:Objective. To assess the efficacy of other biologic therapies, different from IFX and ADA, in patients with Behvet's disease uveitis (BU). Methods. Multicentre study of 124 patients with BU refractory to at least one standard immunosuppressive agent that required IFX or ADA therapy. Patients who had to be switched to another biologic agent due to inefficacy or intolerance to IFX or ADA or patients decision were assessed. The main outcome measures were the degree of anterior and posterior chamber inflammation and macular thickness. Results. Seven-(5.6%) of 124 cases (4 women13 men; mean age, 43 (range 28-67) years; 12 affected eyes) were studied. Five of them had been initially treated with ADA and 2 with IFX. The other biologic agents used were golimumab (n=4), tocilizumab (n=2) and rituximab (n=1). The ocular pattern was panuveitis (n=4) or posterior uveitis (n=3). Uveitis was bilateral in 5 patients (71.4%). At baseline, anterior chamber and vitreous inflammation were present in 6 (50%) and 7 (583%) of the eyes. All the patients (12 eyes) had macular thickening (OCT>250 mu m) and 4 of them (7 eyes), cystoid macular oedema (OCT>300 mu m). Besides reduction anterior chamber and vitreous inflammation, we observed a reduction of OCT values, from 330.4 +/- 58.5 gm at the onset of the biological agent to 273 +/- 50 mu m at month 12 (p=0.06). Six patients achieved a complete remission of uveitis. Conclusion. The vast majority of patients with BU refractory to standard immunosuppressive drugs are successfully controlled with ADA and/or IFX. Other biologic agents also appear to be useful.