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Long-term Follow-up and Optimization of Infliximab in Refractory Uveitis Due to Behçet Disease: National Study of 103 White Patients

Abstract: Objective: In a large series of White patients with refractory uveitis due to Behçet disease (BD) being treated with infliximab (IFX), we assessed (1) long-term efficacy and safety of IFX, and (2) IFX optimization when ocular remission was achieved. Methods: Our multicenter study of IFX-treated patients with BD uveitis refractory to conventional immunosuppressant agents treated 103 patients/185 affected eyes with IFX as first biologic therapy in the following intervals: 3-5 mg/kg intravenous at 0, 2, 6, and then every 4-8 weeks. The main outcome variables were analyzed at baseline, first week, first month, sixth month, first year, and second year of IFX therapy. After remission, based on a shared decision between patient and clinician, IFX optimization was performed. Efficacy, safety, and cost of IFX therapy were evaluated. Results: In the whole series (n = 103), main outcome variables showed a rapid and maintained improvement, reaching remission in 78 patients after a mean IFX duration of 31.5 months. Serious adverse events were observed in 9 patients: infusion reactions (n = 4), tuberculosis (n = 1), Mycobacterium avium pneumonia (n = 1), severe oral ulcers (n = 1), palmoplantar psoriasis (n = 1), and colon carcinoma (n = 1). In the optimization subanalysis, the comparative study between optimized and nonoptimized groups showed (1) no differences in clinical characteristics at baseline, (2) similar maintained improvement in most ocular outcomes, (3) lower severe adverse events, and (4) lower mean IFX costs in the optimized group (€4826.52 vs €9854.13 per patient/yr). Conclusion: IFX seems to be effective and relatively safe in White patients with refractory BD uveitis. IFX optimization is effective, safe, and cost-effective.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: J Rheumatol . 2021 May;48(5):741-750

Editorial: The Journal of Rheumatology Publishing Company Limited

 Año de publicación: 2021

Nº de páginas: 10

Tipo de publicación: Artículo de Revista

 DOI: 10.3899/jrheum.200300

ISSN: 0315-162X

Url de la publicación: https://www.doi.org/10.3899/jrheum.200300

Autores/as

JOSÉ LUIS MARTÍN VARILLAS

BELÉN ATIENZA MATEO

CALVO-RIO, VANESA

BELTRÁN, EMMA

SÁNCHEZ-BURSÓN, JUAN

ADÁN, ALFREDO

HERNÁNDEZ-GARFELLA, MARISA

VALLS-PASCUAL, ELIA

SELLAS-FERNÁNDEZ, AGUSTÍ

ORTEGO, NORBERTO

MAÍZ, OLGA

TORRE, IGNACIO

FERNÁNDEZ-ESPARTERO, CRUZ

JOVANI, VEGA

PEITEADO, DIANA

DÍAZ VALLE, DAVID

ROSALIA DEMETRIO PABLO

RICARDO BLANCO ALONSO