Anti-TNF-α therapy in patients with refractory uveitis due to Behcet's disease: a 1-year follow-up study of 124 patients

被引：103

作者：

Calvo-Rio, Vanesa ^{[1
]}

Blanco, Ricardo ^{[1
]}

Beltran, Emma ^{[2
]}

Sanchez-Burson, Juan ^{[3
]}

Mesquida, Marina ^{[4
]}

Adan, Alfredo ^{[4
]}

Victoria Hernandez, Maria ^{[4
]}

Hernandez Garfella, Marisa ^{[2
]}

Valls Pascual, Elia ^{[5
]}

Martinez-Costa, Lucia ^{[5
]}

Sellas-Fernandez, Agusti ^{[6
]}

Cordero Coma, Miguel ^{[7
]}

Diaz-Llopis, Manuel ^{[8
]}

Gallego, Roberto ^{[8
]}

Salom, David ^{[8
]}

Garcia Serrano, Jose L. ^{[9
]}

Ortego, Norberto ^{[9
]}

Herreras, Jose M. ^{[10
]}

Fonollosa, Alejandro ^{[11
]}

Garcia-Aparicio, Angel M. ^{[12
]}

Maiz, Olga ^{[13
]}

Blanco, Ana ^{[13
]}

Torre, Ignacio ^{[14
]}

Fernandez-Espartero, Cruz ^{[15
]}

Jovani, Vega ^{[16
]}

Peiteado-Lopez, Diana ^{[17
]}

Pato, Esperanza ^{[18
]}

Cruz, Juan ^{[19
]}

Fernandez-Cid, Carlos ^{[19
]}

Aurrecoechea, Elena ^{[20
]}

Garcia, Miriam ^{[21
]}

Caracuel, Miguel A. ^{[22
]}

Montilla, Carlos ^{[23
]}

Atanes, Antonio ^{[24
]}

Francisco Hernandez, Felix ^{[25
]}

Insua, Santos ^{[26
]}

Gonzalez-Suarez, Senen ^{[27
]}

Sanchez-Andrade, Amalia ^{[28
]}

Gamero, Fernando ^{[29
]}

Linares, Luis ^{[30
]}

Romero-Bueno, Fredeswinda ^{[31
]}

Javier Garcia, A. ^{[32
]}

Almodovar, Raquel ^{[33
]}

Minguez, Enrique ^{[34
]}

Carrasco Cubero, Carmen ^{[35
]}

Olive, Alejandro ^{[36
]}

Vazquez, Julio ^{[37
]}

Ruiz Moreno, Oscar ^{[38
]}

Jimenez-Zorzo, Fernando ^{[38
]}

Manero, Javier ^{[38
]}

机构：

[1] Hosp Univ Marques De Valdecilla, IDIVAL, ES-39008 Santander, Spain

[2] Hosp Gen Univ Valencia, Valencia, Spain

[3] Hosp Valme, Seville, Spain

[4] Hosp Clin Barcelona, Barcelona, Spain

[5] Hosp Peset Valencia, Valencia, Spain

[6] Hosp Gen Valle Hebron, Barcelona, Spain

[7] Hosp Leon, Div Ophthalmol, Valencia, Spain

[8] Hosp Univ Fe, Valencia, Spain

[9] Hosp San Cecilio, Granada, Spain

[10] Univ Hosp, IOBA, Valladolid, Spain

[11] Hosp Cruces, Bilbao, Spain

[12] Hosp Toledo, Toledo, Spain

[13] Hosp Donosti San Sebastian, Bilbao, Spain

[14] Hosp Basurto, Bilbao, Spain

[15] Hosp Univ Mostoles, Madrid, Spain

[16] Hosp Gen Alicante, Madrid, Spain

[17] Hosp Univ La Paz Madrid, Madrid, Spain

[18] Hosp Clin San Carlos, Madrid, Spain

[19] Hosp Pontevedra, Torrelavega, Spain

[20] Hosp Sierrallana, Torrelavega, Spain

[21] Hosp Princesa, Madrid, Spain

[22] Hosp Cordoba, La Coruna, Spain

[23] Hosp Univ Salamanca, La Coruna, Spain

[24] HUCA Coruna, La Coruna, Spain

[25] Hosp Doctor Negrin Canarias, La Coruna, Spain

[26] Hosp Univ Santiago Compostela, La Coruna, Spain

[27] Hosp Cabuenes, Gijon, Spain

[28] Hosp Lucus Augusti, Lugo, Spain

[29] Hosp San Pedro Alcantara, Caceres, Spain

[30] Hosp Arrixaca, Murcia, Spain

[31] Fdn Jimenez Diaz, Madrid, Spain

[32] Hosp 12 Octubre, E-28041 Madrid, Spain

[33] Hosp Univ Fdn Alcorcon, Badalona, Spain

[34] Hosp Clin Zaragoza, Badalona, Spain

[35] Hosp Merida, Badalona, Spain

[36] Hosp Univ Germans Trias Pujol, Badalona, Spain

[37] Hosp Ferrol, La Coruna, Spain

[38] Rheumatol Hosp Miguel Servet, Zaragoza, Spain

[39] Rheumatol Hosp Univ Infanta Sofia, Madrid, Spain

来源：

RHEUMATOLOGY | 2014年 / 53卷 / 12期

关键词：

Behcet's disease; uveitis; anti-TNF therapy; TUMOR-NECROSIS-FACTOR; LONG-TERM EFFICACY; POSTERIOR UVEITIS; AQUEOUS-HUMOR; INFLIXIMAB; ADALIMUMAB; MULTICENTER; SAFETY; SERUM; MANIFESTATIONS;

D O I：

10.1093/rheumatology/keu266

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objective. The aim of this study was to assess the efficacy of anti-TNF-alpha therapy in refractory uveitis due to Behcet's disease (BD). Methods. We performed a multicentre study of 124 patients with BD uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. Patients were treated for at least 12 months with infliximab (IFX) (3-5 mg/kg at 0, 2 and 6 weeks and then every 4-8 weeks) or adalimumab (ADA) (usually 40 mg every 2 weeks). The main outcome measures were degree of anterior and posterior chamber inflammation, visual acuity, macular thickness and immunosuppression load. Results. Sixty-eight men and 56 women (221 affected eyes) were studied. The mean age was 38.6 years (S.D. 10.4). HLA-B51 was positive in 66.1% of patients and uveitis was bilateral in 78.2%. IFX was the first biologic agent in 77 cases (62%) and ADA was first in 47 (38%). In most cases anti-TNF-alpha drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-alpha therapy, anterior chamber and vitreous inflammation was observed in 57% and 64.4% of patients, respectively. In both conditions the damage decreased significantly after 1 year. At baseline, 50 patients (80 eyes) had macular thickening [optical coherence tomography (OCT) >250 mu m] and 35 (49 eyes) had cystoid macular oedema (OCT > 300 mu m) that improved from 420 mm (S.D. 119.5) at baseline to 271 mu m (S.D. 45.6) at month 12 (P < 0.01). The best-corrected visual acuity and the suppression load also showed significant improvement. After 1 year of follow-up, 67.7% of patients were inactive. Biologic therapy was well tolerated in most cases. Conclusion. Anti-TNF-alpha therapy is effective and relatively safe in refractory BD uveitis.

引用

页码：2223 / 2231

页数：9

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