Masaru Takeuchi1, Takeshi Kezuka2, Sunao Sugita3, Hiroshi Keino4, Kenichi Namba5, Toshikatsu Kaburaki6, Kazuichi Maruyama7, Kei Nakai8, Kuniaki Hijioka9, Etsuko Shibuya10, Keiko Komae6, Junko Hori11, Nobuyuki Ohguro12, Koh-hei Sonoda13, Nobuhisa Mizuki10, Annabelle A Okada4, Tatsuro Ishibashi9, Hiroshi Goto2, Manabu Mochizuki14. 1. Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan. Electronic address: masatake@ndmc.ac.jp. 2. Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan. 3. Laboratory for Retinal Regeneration, Center for Developmental Biology, RIKEN, Kobe, Japan. 4. Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan. 5. Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 6. Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan. 7. Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. 8. Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan. 9. Department of Ophthalmology, Graduate School of Medicine, Kyushu University, Fukuoka City, Japan. 10. Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan. 11. Department of Ophthalmology, Nippon Medical School, Tokyo, Japan. 12. Department of Ophthalmology, Osaka Koseinennkinn Hospital, Osaka, Japan. 13. Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. 14. Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: To evaluate the long-term efficacy and safety of infliximab for the treatment of uveitis in Behçet's disease (BD). DESIGN: Retrospective multicenter study using a questionnaire. PARTICIPANTS: A total of 164 consecutive patients with BD treated with infliximab for more than 1 year were studied. The mean age at initiation of infliximab treatment was 42.6±11.7 years, and the mean treatment duration was 32.9±14.4 months. METHODS: Data before and at the last visit during infliximab treatment were analyzed in 4 groups divided by duration of treatment: group A (n = 43, 12-<24 months), group B (n = 62, 24-<36 months), group C (n = 42, 36-<48 months), and group D (n = 17, ≥48 months). MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), relapse of ocular inflammation, numbers of ocular inflammatory attacks per year, and adverse effects of infliximab therapy. RESULTS: The frequency of ocular attacks decreased in all groups (from 5.3±3.0 to 1.0±0.3 in group A, 4.8±4.6 to 1.4±0.3 in group B, 4.1±2.9 to 0.9±0.3 in group C, and 9.5±5.8 to 1.6±0.5 in group D; all P < 0.05). The BCVA was improved in approximately 55% of the eyes after treatment. Mean BCVA converted to logarithm of the minimum angle of resolution was improved after treatment with infliximab in groups A to C (from 0.79±1.04 to 0.59±0.94 in group A, 0.59±1.07 to 0.41±1.04 in group B, and 1.15±1.77 to 0.92±1.73 in group C; all P < 0.05) but not in group D. Uveitis relapsed in 59.1% of all patients after infliximab treatment, and no difference in duration until relapse was observed between individual groups. Approximately 80% of relapses occurred within 1 year after the initiation of infliximab treatment in all groups, 90% of which were controlled by increasing doses of topical corticosteroids and shortening the interval of infliximab infusion. Adverse effects were observed in 65 cases or 35% of all subjects. Infliximab treatment was continued in 85% of the patients, but 15% of the patients discontinued infliximab treatment because of adverse effects or insufficient efficacy. CONCLUSIONS: Infliximab reduced the frequency of ocular attacks and improved visual acuity in patients with BD-related uveitis and was generally well tolerated with few serious adverse events.
PURPOSE: To evaluate the long-term efficacy and safety of infliximab for the treatment of uveitis in Behçet's disease (BD). DESIGN: Retrospective multicenter study using a questionnaire. PARTICIPANTS: A total of 164 consecutive patients with BD treated with infliximab for more than 1 year were studied. The mean age at initiation of infliximab treatment was 42.6±11.7 years, and the mean treatment duration was 32.9±14.4 months. METHODS: Data before and at the last visit during infliximab treatment were analyzed in 4 groups divided by duration of treatment: group A (n = 43, 12-<24 months), group B (n = 62, 24-<36 months), group C (n = 42, 36-<48 months), and group D (n = 17, ≥48 months). MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), relapse of ocular inflammation, numbers of ocular inflammatory attacks per year, and adverse effects of infliximab therapy. RESULTS: The frequency of ocular attacks decreased in all groups (from 5.3±3.0 to 1.0±0.3 in group A, 4.8±4.6 to 1.4±0.3 in group B, 4.1±2.9 to 0.9±0.3 in group C, and 9.5±5.8 to 1.6±0.5 in group D; all P < 0.05). The BCVA was improved in approximately 55% of the eyes after treatment. Mean BCVA converted to logarithm of the minimum angle of resolution was improved after treatment with infliximab in groups A to C (from 0.79±1.04 to 0.59±0.94 in group A, 0.59±1.07 to 0.41±1.04 in group B, and 1.15±1.77 to 0.92±1.73 in group C; all P < 0.05) but not in group D. Uveitis relapsed in 59.1% of all patients after infliximab treatment, and no difference in duration until relapse was observed between individual groups. Approximately 80% of relapses occurred within 1 year after the initiation of infliximab treatment in all groups, 90% of which were controlled by increasing doses of topical corticosteroids and shortening the interval of infliximab infusion. Adverse effects were observed in 65 cases or 35% of all subjects. Infliximab treatment was continued in 85% of the patients, but 15% of the patients discontinued infliximab treatment because of adverse effects or insufficient efficacy. CONCLUSIONS:Infliximab reduced the frequency of ocular attacks and improved visual acuity in patients with BD-related uveitis and was generally well tolerated with few serious adverse events.
Authors: Claudia Fabiani; Antonio Vitale; Donato Rigante; Giacomo Emmi; Giuseppe Lopalco; Jurgen Sota; Lorenzo Vannozzi; Gerardo di Scala; Silvana Guerriero; Ida Orlando; Rossella Franceschini; Marco Capozzoli; Bruno Frediani; Mauro Galeazzi; Florenzo Iannone; Gian Marco Tosi; Luca Cantarini Journal: Clin Rheumatol Date: 2018-04-18 Impact factor: 2.980