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

To assess the efficacy of other biologic therapies, different from infliximab (IFX) and adalimumab (ADA), in patients with Behçet's disease uveitis (BU). Multicenter study of 124 patients with BU refractory to at least one standard immunosuppressive agent that required IFX or ADA therapy. Patie...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2016-09, Vol.34 (6 Suppl 102), p.S34-S40
Main Authors: Santos-Gómez, Montserrat, Calvo-Río, Vanesa, Blanco, Ricardo, Beltrán, Emma, Mesquida, Marina, Adán, Alfredo, Cordero-Coma, Miguel, García-Aparicio, Ángel M, Valls Pascual, Elia, Martínez-Costa, Lucía, Hernández, María Victoria, Hernandez Garfella, Marisa, González-Vela, María C, Pina, Trinitario, Palmou-Fontana, Natalia, Loricera, Javier, Hernández, José L, González-Gay, Miguel A
Format: Article
Language:English
Subjects:
Adalimumab - adverse effects
Adalimumab - therapeutic use
Adult
Aged
Behcet Syndrome - diagnosis
Behcet Syndrome - drug therapy
Behcet Syndrome - immunology
Biological Products - adverse effects
Biological Products - therapeutic use
Drug Resistance
Drug Substitution
Female
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Infliximab - adverse effects
Infliximab - therapeutic use
Male
Middle Aged
Remission Induction
Spain
Time Factors
Treatment Outcome
Uveitis - diagnosis
Uveitis - drug therapy
Uveitis - immunology
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Summary:To assess the efficacy of other biologic therapies, different from infliximab (IFX) and adalimumab (ADA), in patients with Behçet's disease uveitis (BU). Multicenter 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 patient's decision were assessed. The main outcome measures were the degree of anterior and posterior chamber inflammation and macular thickness. Seven (5.6%) of 124 cases (4 women/3 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 (58.3%) of the eyes. All the patients (12 eyes) had macular thickening (OCT>250μm) and 4 of them (7 eyes), cystoid macular edema (OCT>300 μm). Besides reduction anterior chamber and vitreous inflammation, we observed a reduction of OCT values, from 330.4±58.5 μm at the onset of the biological agent to 273±50 μm at month 12 (p=0.06). Six patients achieved a complete remission of uveitis. The vast majority of patients with BU refractory to standard immunosuppressive drugs are successfully controlled with ADA and/or IFX. Other biologic agents appear to be also useful.
ISSN:0392-856X
1593-098X