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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

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18

  1. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  2. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  3. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain. rblanco@humv.es
  4. Rheumatology and Ophthalmology, Hospital General Universitario de Valencia, Spain.
  5. Ophthalmology and Rheumatology, Hospital Clinic, Barcelona, Spain.
  6. Ophthalmology and Rheumatology, Hospital Clinic, Barcelona, Spain.
  7. Ophthalmology, Hospital de León, Spain.
  8. Rheumatology, Hospital de Toledo, Spain.
  9. Rheumatology and Ophthalmology, Hospital Peset Valencia, Spain.
  10. Rheumatology and Ophthalmology, Hospital Peset Valencia, Spain.
  11. Ophthalmology and Rheumatology, Hospital Clinic, Barcelona, Spain.
  12. Rheumatology and Ophthalmology, Hospital General Universitario de Valencia, Spain.
  13. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  14. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  15. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  16. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  17. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  18. Rheumatology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain. miguelaggay@hotmail.com

CER8957 Submission on line
2016 Vol.34, N°6 ,Suppl.102 - PI 0034, PF 0040
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
To assess the efficacy of other biologic therapies, different from infliximab (IFX) and adalimumab (ADA), in patients with Behçet’s disease uveitis (BU).
METHODS:
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.
RESULTS:
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.
CONCLUSIONS:
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.

PMID: 27054359 [PubMed]

Received: 09/09/2015 - Accepted : 18/11/2015 - In Press: 07/04/2016 - Published: 25/10/2016