Abstract
Introduction: Behcet’s uveitis is a serious sight-threatening condition that may lead to blindness if not appropriately managed. The aim of the present study is to evaluate long-term effectiveness of infliximab in resistant Behcet’s uveitis. Methods: Medical records of 32 patients (56 eyes) were retrospectively analysed. Primary outcomes included ocular inflammatory activity, frequency of uveitis attacks and steroidsparing effect. Results: Mean follow-up was 33,2 months while mean age of patients at disease onset was 33,3 years. Ocular inflammation was bilateral in 75% of cases and consisted in panuveitis in 46,4 % of affected eyes. All patients received intravenous infusions of infliximab (5mg/kg) at weeks 0, 2, 4, 6 and every 6-8 weeks thereafter. Clinical remission was observed in 26 out 32 patients (81,2%). Mean number of uveitis attacks decreased from 2,56 to 0,65 during infliximab therapy (p<0.001) while systemic corticosteroids were tapered in 17 patients and suspended in 10 (31,2%). Conclusions: Our study suggested that infliximab is long-term effective in resistant Behcet uveitis, improving visual prognosis and stabilising clinical course of disease in a large cohort of patients with various pattern of BD including neuro-behcet forms.
Highlights
Behçet’s uveitis is a serious sight-threatening condition that may lead to blindness if not appropriately managed
Tumor Necrosis Factor-α (TNFα) is a cytokine involved in establishment and maintenance of inflammatory response and, even specific aetiopathogenesis of Behçet’s disease (BD) is still unclear, experimental data suggest that TNFα may play a key-role in development of BD [3,4]
Infliximab is a chimeric monoclonal antibody binding with high affinity both soluble and membrane-bound TNFα molecules so to inhibit an extensive range of its biologic activities
Summary
Behçet’s uveitis is a serious sight-threatening condition that may lead to blindness if not appropriately managed. The aim of the present study is to evaluate long-term effectiveness of infliximab in resistant Behçet’s uveitis. Severe forms of Behcet’s uveitis may produce serious visual impairment with potential blindness of affected patients. Main goals of Behçet’s uveitis management are prompt resolution of intraocular inflammation, prevention of recurrent attacks and preservation of vision. Its use has greatly increased over last year’s representing an effective therapeutic approach in BD [5,6,7,8] and previous studies have reported surprising results in severe forms of Behcet’s uveitis [9,10,11,12,13,14]
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