Anti-TNF- therapy in patients with refractory uveitis due to Behcet's disease: a 1-year follow-up study of 124 patients
| Autor: | Carmen Carrasco Cubero, Ricardo Blanco, Fredeswinda Romero-Bueno, Lucía Martínez-Costa, Ignacio García-De La Torre, Maria Victoria Hernández, L. Linares, Carlos Montilla, Antonio Atanes, Félix Francisco Hernandez, Fernando Gamero, Marisa Hernandez Garfella, Elena Aurrecoechea, Amalia Sánchez-Andrade, Manuel Díaz-Llopis, O. Maíz, J. Vazquez, Raquel Almodóvar, M.A. Caracuel, Oscar Ruiz Moreno, Emma Beltrán, Elia Valls Pascual, Marina Mesquida, Senén González-Suárez, Miguel Cordero Coma, Esperanza Pato, Juan Cruz, Javier Rueda-Gotor, Miguel A. González-Gay, David Salom, Fernando Jiménez-Zorzo, José Luis García Serrano, Vega Jovani, Ángel García-Aparicio, José M. Herreras, M A García, Enrique Minguez, Santiago Muñoz Fernández, Agusti Sellas-Fernández, Ana Blanco, Javier Manero, A Javier García, Diana Peiteado-Lopez, Cruz Fernández-Espartero, Roberto Gallego, Carlos Marras Fernandez-Cid, Vanesa Calvo-Río, Alejandro Olivé, Juan Sánchez-Bursón, Norberto Ortego, Alejandro Fonollosa, Santos Insua, Alfredo Adán |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Adolescent genetic structures medicine.medical_treatment Drug Resistance Behcet's disease Antibodies Monoclonal Humanized Gastroenterology Drug Administration Schedule Uveitis Young Adult Rheumatology Refractory Prednisone Internal medicine Adalimumab medicine Humans Pharmacology (medical) Child Glucocorticoids Aged Biological Products Tumor Necrosis Factor-alpha business.industry Behcet Syndrome Antibodies Monoclonal Immunosuppression Middle Aged medicine.disease Infliximab eye diseases Treatment Outcome Immunology Drug Therapy Combination Female medicine.symptom business Immunosuppressive Agents Follow-Up Studies medicine.drug |
| Zdroj: | Rheumatology. 53:2223-2231 |
| ISSN: | 1462-0332 1462-0324 |
| DOI: | 10.1093/rheumatology/keu266 |
| Popis: | OBJECTIVE: The aim of this study was to assess the efficacy of anti-TNF-α therapy in refractory uveitis due to Behcet'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-α drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-α 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-α therapy is effective and relatively safe in refractory BD uveitis. |
| Databáze: | OpenAIRE |
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