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Cumulative retention rate of adalimumab in patients with Behçet's disease-related uveitis: a four-year follow-up study
  1. Claudia Fabiani1,
  2. Jurgen Sota2,
  3. Antonio Vitale2,
  4. Donato Rigante3,
  5. Giacomo Emmi4,
  6. Lorenzo Vannozzi5,
  7. Daniela Bacherini5,
  8. Giuseppe Lopalco6,
  9. Silvana Guerriero7,
  10. Stefano Gentileschi2,
  11. Marco Capozzoli8,
  12. Rossella Franceschini8,
  13. Bruno Frediani2,
  14. Mauro Galeazzi2,
  15. Florenzo Iannone6,
  16. Gian Marco Tosi8,
  17. Luca Cantarini2
  1. 1Department of Ophthalmology, Humanitas Clinical and Research Center, Milan, Italy
  2. 2Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Auto inflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, University of Siena, Siena, Italy
  3. 3Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico, Universitario “A. Gemelli”, Rome, Italy
  4. 4Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  5. 5Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy
  6. 6Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy
  7. 7Department of Ophthalmology and Otolaryngology, University of Bari, Bari, Italy
  8. 8Department Ophthalmology and Neurosurgery, University of Siena, Siena, Italy
  1. Correspondence to Claudia Fabiani, Department of Ophthalmology, Humanitas Clinical and ResearchCenter, via Manzoni 56, 20089 Rozzano, Milan, Italy; claudia.fabiani{at}gmail.com and Dr Luca Cantarini, Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Auto inflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, University of Siena, Viale Bracci 1, Siena, 53100, Italy; cantariniluca{at}hotmail.com

Abstract

Background/aims Adalimumab (ADA) has been shown to be an effective treatment for Behçet’s disease (BD)-related uveitis. We aimed at evaluating the cumulative retention rate of ADA during a 48-month follow-up period in patients with BD-related uveitis, the impact of a concomitant use of disease modifying anti-rheumatic drugs (DMARDs) on ADA retention rate, and differences according to the various lines of biologic therapy (ie, first- vs second-line or more). Predictive factors of response to ADA were also investigated.

Methods We enrolled patients diagnosed with BD-related uveitis and treated with ADA between January 2009 and December 2016. Cumulative survival rates were studied using the Kaplan-Meier plot, while the log-rank (Mantel-Cox) test was used to compare survival curves. Statistical analysis was performed to identify differences according to the response to ADA.

Results 54 consecutive patients (82 eyes) were eligible for analysis. The drug retention rate at 12- and 48-month follow-up was 76.9% and 63.5%, respectively. No statistically significant differences were identified according to the use of concomitant DMARDs (p=0.27) and to the different lines of ADA treatment (p=0.37). No significant differences were found between patients continuing and discontinuing ADA in terms of age (p=0.24), age at BD onset (p=0.81), age at uveitis onset (p=0.56), overall BD duration (p=0.055), uveitis duration (p=0.46), human leucocyte antigen-B51 positivity (p=0.51), and gender (p=0.47).

Conclusions ADA retention rate in BD-related uveitis is excellent and is not affected by the concomitant use of DMARDs or by the different lines of biological therapy. Negative prognostic factors for BD uveitis do not impact ADA efficacy.

  • Behçet’s disease
  • uveitis
  • adalimumab
  • drug retention rate

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Footnotes

  • Contributors CF, JS and LC wrote the manuscript; LC, CF designed the study; CF, GM, LC and MG revised the final manuscript; AV, FI and DR performed the data analysis; GE, LV, DB, GL, SG, SG, MC, RF, BF, AV and LC took care of patient enrolment, follow-up of the patients, and data collection.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Azienda Ospedaliera Universitaria Senese.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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