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Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis Due to Behçet's Disease: National Multicenter Study of 177 Cases

Abstract: Objective: To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD). Methods: We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement. Patients received 3-5 mg/kg intravenous IFX at 0, 2, and 6 weeks and every 4-8 weeks thereafter, or 40 mg subcutaneous ADA every other week without a loading dose. Ocular parameters were compared between the 2 groups. Results: The study included 177 patients (316 affected eyes), of whom 103 received IFX and 74 received ADA. There were no significant baseline differences between treatment groups in main demographic features, previous therapy, or ocular sign severity. After 1 year of therapy, we observed an improvement in all ocular parameters in both groups. However, patients receiving ADA had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for IFX; P = 0.06), improvement in vitritis (93.33% versus 78.95% for IFX; P = 0.04), and best-corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for IFX; P = 0.001). A nonsignificant difference was seen for macular thickness (mean ± SD 250.62 ± 36.85 for ADA versus 264.89 ± 59.74 for IFX; P = 0.15), and improvement in retinal vasculitis was similar between the 2 groups (95% for ADA versus 97% for IFX; P = 0.28). The drug retention rate was higher in the ADA group (95.24% versus 84.95% for IFX; P = 0.042). Conclusion: Although both IFX and ADA are efficacious in refractory BD-related uveitis, ADA appears to be associated with better outcomes than IFX after 1 year of follow-up.

 Fuente: Arthritis Rheumatol , 71 (12), 2081-2089

 Publisher: John Wiley and Sons Ltd

 Year of publication: 2019

 No. of pages: 9

 Publication type: Article

 DOI: 10.1002/art.41026

 ISSN: 2326-5205,2326-5191

 Publication Url: https://www.doi.org/10.1002/art.41026

Authorship

ATIENZA MATEO, BELÉN

MARTÍN VARILLAS, JOSÉ LUIS

CALVO-RÍO, VANESA

ROSALIA DEMETRIO PABLO

BELTRÁN, EMMA

SÁNCHEZ-BURSÓN, JUAN

MESQUIDA, MARINA

ADAN, ALFREDO

HERNÁNDEZ, MARÍA VICTORIA

HERNÁNDEZ-GARFELLA, MARISA

VALLS-PASCUAL, ELIA

MARTÍNEZ-COSTA, LUCÍA

SELLAS-FERNÁNDEZ, AGUSTÍ

CORDERO-COMA, MIGUEL

DÍAZ-LLOPIS, MANUEL

GALLEGO, ROBERTO

MARIA PAZ RODRIGUEZ CUNDIN