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Long-term efficacy of early infliximab-induced remission for refractory uveoretinitis associated with Behçet’s disease
  1. Hiroshi Keino1,
  2. Takayo Watanabe1,
  3. Makiko Nakayama1,
  4. Yoshinori Komagata2,
  5. Kazuhito Fukuoka2,
  6. Annabelle A Okada1
  1. 1 Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
  2. 2 Department of Rheumatology and Nephrology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
  1. Correspondence to Annabelle A Okada, Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan; aokada{at}e23.jp

Abstract

Background To evaluate long-term efficacy of infliximab (IFX) in refractory uveoretinitis associated with Behçet’s disease (BD) depending on uveoretinitis duration.

Methods Records of 16 patients with BD (32 eyes) followed for >5 years after starting IFX, were retrospectively reviewed. Long-term efficacy was compared between patients with short duration (≤18 months, n=7) versus long duration (>18 months, n=9) of their uveoretinitis prior to starting IFX.

Results The median follow-up after starting IFX was 132 months (76–146 months). Mean frequency of attacks and the 1-year Behçet’s Disease Ocular Attack Score 24 decreased significantly over 10 years. Overall, the percentage of eyes with a best-corrected visual acuity (BCVA) ≥1.0 increased from 47% at baseline to 59% at 5 years; the percentage of eyes with a BCVA ≤0.1 was 19% at both baseline and 5 years. The frequency of ocular attacks decreased similarly in both short duration and long duration groups; however, the percentage of eyes with a BCVA ≥1.0 at 5 years was 100% in the short duration group versus 28% in the long duration group. IFX was discontinued in four patients with an excellent response to IFX therapy; all were young male patients in the short duration group with good BCVA bilaterally, and none had inflammatory recurrences over a median follow-up of 56 months off IFX.

Conclusion Initiation of IFX therapy in patients with BD within 18 months of their uveoretinitis onset was more effective in maintaining good BCVA than after 18 months.

  • Inflammation
  • Treatment Medical

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Footnotes

  • Contributors HK and AAO designed the study and HK wrote the initial draft of the manuscript. HK and AAO contributed to analysis and interpretation of data, and TW and MN assisted in the preparation of the manuscript. TW, MN, YK and KF have contributed to data collection and interpretation and critically reviewed the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests HK: lecture fees from Nikon (Japan), Mitsubishi Tanabe Pharma (Japan), Bayer (Japan) and Senju Pharmaceutical (Japan). AAO: research funds from Bayer (Japan); consultant fees from Bayer (Japan and Germany), Chugai Pharmaceutical (Japan), Novartis (Japan), HOYA (Japan), Daiichi Sankyo (Japan), Astellas (Japan); lecture fees from Novartis (Japan), Bayer (Japan), Pfizer (Japan), Santen (Japan), Mitsubishi Tanabe Pharma (Japan), Allergan (Japan), Senju Pharmaceutical (Japan), AbbVie (Japan) and Otsuka Pharmaceutical (Japan).

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

  • Data availability statement Data are available upon reasonable request.

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