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Anti-TNF vs tocilizumab in refractory uveitic cystoid macular edema due to Behcet's disease. Multicenter study of 49 patients

Abstract: Objective To compare the efficacy of TNF inhibitors (adalimumab (ADA) and infliximab (IFX)) vs tocilizumab (TCZ) in patients with refractory cystoid macular edema (CME) due to Behçet's disease (BD). Methods Multicenter study of patients with BD-associated CME refractory to conventional and/or biological immunosuppressive drugs. From a cohort of 177 patients treated with anti-TNF and 14 patients treated with TCZ, we selected those with CME at baseline. We analyzed the evolution of macular thickness (main outcome), best-corrected visual acuity (BCVA) and intraocular inflammation (Tyndall and vitritis) from baseline up to 4 years in the 3 groups mentioned. Results 49 patients and 72 eyes with CME were included. ADA was used in 25 patients (40 eyes), IFX in 15 (21 eyes) and TCZ in 9 (11 eyes). No statistically significant baseline differences were observed between the 3 groups except for a lower basal BCVA in TCZ group and a higher basal degree of intraocular inflammation in ADA group. Most patients from all groups had received several conventional immunosuppressive drugs. In addition, most patients in the group of TCZ had also received anti-TNF agents. Biological therapy was used in monotherapy (n=8) or combined with conventional immunosuppressive drugs (n=41). Macular thickness progressively decreased in the 3 groups, with no signs of CME after 1 year of treatment. Similarly, BCVA improvement and inflammatory intraocular remission was achieved in all groups. Conclusion Refractory CME associated with BD uveitis can be effectively treated either with ADA, IFX or TCZ. Furthermore, TCZ is effective in patients resistant to anti-TNF therapy.

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

 Fuente: Seminars in Arthritis and Rheumatism, 2023, 58, 152153

Editorial: Elsevier

 Año de publicación: 2023

Nº de páginas: 7

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.semarthrit.2022.152153

ISSN: 0049-0172,1532-866X

Url de la publicación: https://doi.org/10.1016/j.semarthrit.2022.152153

Autoría

BARROSO-GARCÍA, NURIA

BELÉN ATIENZA MATEO

FERRAZ-AMARO, IVÁN

DIANA PRIETO PEÑA

BELTRÁN, EMMA

ADÁN, ALFREDO

HERNÁNDEZ-GARFELLA, MARISA

MARTÍNEZ-COSTA, LUCÍA

CORDERO-COMA, MIGUEL

DÍAZ-LLOPIS, MANUEL

HERRERAS, JOSÉ M

MAÍZ-ALONSO, OLGA

TORRE-SALABERRI, IGNACIO

VICENTE-DELMÁS, ANA DE

DÍAZ-VALLE, DAVID

ATANES-SANDOVAL, ANTONIO

FRANCISCO, FÉLIX

INSUA, SANTOS