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

Abstract: OBJECTIVE: The aim of this study was to assess the efficacy of anti-TNF-a therapy in refractory uveitis due to Behçet'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-a drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-a 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 µm] and 35 (49 eyes) had cystoid macular oedema (OCT>300 µm) that improved from 420 µm (s.d. 119.5) at baseline to 271 µm (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-a therapy is effective and relatively safe in refractory BD uveitis.

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

 Fuente: Rheumatology (Oxford). 2014 Dec;53(12):2223-31

Editorial: Oxford University Press

 Fecha de publicación: 01/11/2014

Nº de páginas: 9

Tipo de publicación: Artículo de Revista

 DOI: 10.1093/rheumatology/keu266.

ISSN: 1462-0324,1462-0332

Proyecto español: RD12/0009/0013

Autores/as

CALVO RÍO, VANESA

RICARDO BLANCO ALONSO

BELTRÁN, EMMA

SÁNCHEZ BURSÓN, JUÁN

MESQUIDA, MARINA

ADÁN, ALFREDO

HERNÁNDEZ, MARÍA VICTORIA

HERNÁNDEZ GARFELLA, MARISA

VALLS PASCUAL, ELIA

MARTÍNEZ COSTA, LUCÍA

SELLAS FERNÁNDEZ, AGUSTÍ

CORDERO COMA, MIGUEL

DÍAZ LLOPIS, MANUEL

GALLEGO, ROBERTO

SALOM, DAVID

GARCÍA SERRANO, JOSÉ L.

ORTEGO, NORBERTO

HERRERAS, JOSÉ M.