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Induction of ocular Behçet’s disease remission after short-term treatment with infliximab: a case series of 11 patients with a follow-up from 4 to 16 years
P.P. Sfikakis1, A. Arida2, D.S. Ladas3, N. Markomichelakis4
- Rheumatology Unit, First Department of Propedeutic Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens Medical School, Greece. psfikakis@med.uoa.gr
- Rheumatology Unit, First Department of Propedeutic Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens Medical School, Greece.
- Rheumatology Unit, First Department of Propedeutic Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens Medical School, Greece.
- Rheumatology Unit, First Department of Propedeutic Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens Medical School, Greece.
CER12779
2019 Vol.37, N°6 ,Suppl.121
PI 0137, PF 0141
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PMID: 31856941 [PubMed]
Received: 16/09/2019
Accepted : 23/10/2019
In Press: 09/12/2019
Published: 09/12/2019
Abstract
OBJECTIVES:
Initial recommendations on anti-TNF treatment for Behçet’s disease (BD) included an intravenous infliximab infusion for acute posterior uveitis to achieve a fast-onset response. We aimed to examine the long-term outcome of our patients with acute sight-threatening BD who received successful short-term treatment with infliximab.
METHODS:
We performed a retrospective longitudinal outcome study including consecutive patients who responded to one infliximab infusion (5mg/kg) for BD-associated acute posterior uveitis or panuveitis, followed, or not, by one or two additional infusions.
RESULTS:
Twelve patients (aged 51±14 years, mean±SD, 67% men) with bilateral (n=9) or unilateral (n=3) ocular attack (relapsing in 9 patients) achieved resolution of ocular inflammation within 4 weeks after the first infusion of infliximab, given as add-on to azathioprine (n=9) or to azathioprine/cyclosporine combination. Ten of 12 patients received a second infusion at 4 weeks and 9 of them received a third infusion at 8 weeks from baseline. Except from a patient who relapsed after 6 months and responded to infliximab re-treatment, 11 patients remain ocular relapse-free during follow-up, ranging from 4 to 16 years (10±4). Five patients (45%) discontinued azathioprine being in full BD remission and remain any drug-free at end of follow-up.
CONCLUSIONS:
Successful short-term infliximab treatment combined with conventional immunosuppressives for BD-associated sight-threatening uveitis may lead to remission for many years thereafter. This observation may suggest that infliximab as a first-line therapy should be promptly administered to every patient with ocular BD for rapid remission of ocular inflammation and preservation of visual acuity.
