Anti-TNF-alpha therapy in patients with refractory uveitis due to Behcet's disease: a 1-year follow-up study of 124 patients

Fecha de publicación: 01/12/2014

Autores de IIS La Fe

Eduardo Beltran Beleña

Autor
Elia Valls Pascual

Autor
Manuel Díaz Llopis

Autor
Roberto Gallego Pinazo

Autor
David Salom Alonso

Autor

Participantes ajenos a IIS La Fe

Calvo-Río V
Blanco R
Sánchez-Bursón J
Mesquida M
Adán A
Hernandez MV
Hernandez Garfella M
Martínez-Costa L
Sellas-Fernández A
Cordero Coma M
García Serrano JL
Ortego N
Herreras JM
Fonollosa A
García-Aparicio AM
Maíz O
Blanco A
Torre I
Fernández-Espartero C
Jovani V
Peiteado-Lopez D
Pato E
Cruz J
Fernández-Cid C
Aurrecoechea E
García M
Caracuel MA
Montilla C
Atanes A
Hernandez FF
Insua S
González-Suárez S
Sánchez-Andrade A
Gamero F
Linares L
Romero-Bueno F
García AJ
Almodovar R
Minguez E
Carrasco Cubero C
Olive A
Vázquez J
Ruiz Moreno O
Jiménez-Zorzo F
Manero J
Muñoz Fernández S
Rueda-Gotor J
González-Gay MA

Grupos

Biomedicina Molecular, Celular y Genómica

Leader

José María Millán Salvador

Abstract

Objective. The aim of this study was to assess the efficacy of anti-TNF-alpha 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-alpha drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-alpha 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 mu m] and 35 (49 eyes) had cystoid macular oedema (OCT > 300 mu m) that improved from 420 mm (S.D. 119.5) at baseline to 271 mu m (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-alpha therapy is effective and relatively safe in refractory BD uveitis.

Datos de la publicación

ISSN/ISSNe:: 1462-0324, 1462-0332
Tipo:: Article
Páginas:: 2223-2231
DOI:: 10.1093/rheumatology/keu266
Factor de Impacto:: 2,243 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Keywords

Behcet's disease; uveitis; anti-TNF therapy

Campos de estudio

Proyectos asociados

PATRONES DE RM CEREBRAL Y MEDULAR EN RELACION CON LA PRESENCIA DE AUTOANTIGENOS NEURONALES RECONOCIDOS POR INMUNOGLOBULINAS M PRESENTES EN EL LIQUIDO CEFALORRAQUIDEO DE PACIENTES DE ESCLEROSIS MULTIPLE.

Investigador Principal: ISABEL BOSCÁ BLASCO

MERCK SERONO DR. CASANOVA . ALMIRALL S.A; FUNDACIÓN BIOGEN IDEC; MERCK S.L.U; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2010