Evaluation of the Long-Term Efficacy and Safety of Infliximab Treatment for Uveitis in Behçet's Disease

Takeuchi, Masaru; Kezuka, Takeshi; Sugita, Sunao; Keino, Hiroshi; Namba, Kenichi; Kaburaki, Toshikatsu; Maruyama, Kouichi; Nakai, Kei; Hijioka, Kuniaki; Shibuya, Etsuko; Komae, Keiko; Hori, Junko; Ohguro, Nobuyuki; Sonoda, Koh Hei; Mizuki, Nobuhisa; Okada, Annabelle A.; Ishibashi, Tatsuro; Gotô, Hiroshi; Mochizuki, Manabu

doi:10.1016/j.ophtha.2014.04.042

Cited by 106 publications

(68 citation statements)

References 38 publications

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“…However, the incidence of secondary failure due to ATI production in BD remains unknown. Moreover, there are no randomized studies comparing combined ), with anti-TNF-a monotherapy in patients with BD-related uveitis, although concomitant therapy may achieve better disease control and/or reductions in anti-TNF-a agent immunogenicity (7,17). In this study, loss of IFX efficacy may not have been caused by a lack or shortage of concomitant medications because the group that underwent therapy intensification (group II) actually received a higher dose of corticosteroids and was also more likely to use additional medications, such as colchicine and CsA (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease

et al. 2018

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Objective: To assess the long-term efficacy and safety of infliximab (IFX) treatment for refractory uveitis associated with Behçet's disease (BD) and to identify predictors of long-term IFX therapy outcomes. Material and Methods: We retrospectively studied 44 consecutive BD patients with uveitis who were started on IFX therapy and analyzed the efficacy and safety of IFX and the treatment continuation rate. To determine predictors of IFX responsiveness, we analyzed the clinical characteristics of the patients who received regular maintenance therapy and those who required treatment intensification. The serum cytokine levels prior to IFX were measured through the Bio-Plex human cytokine assays. Results: IFX significantly reduced the frequency of ocular attacks and improved the visual acuity of patients with BD-related uveitis. However, approximately half of the patients required dose escalations, necessitating a shortening of the intervals between IFX infusions due to loss of efficacy during the 5-year treatment. The frequency of ocular attacks was significantly higher in patients with complete BD than in patients with incomplete BD. A multiplex cytokine analysis revealed that patients with BD-related uveitis exhibited increased serum IL-2, IL-6, IL-8, and MCP-1 levels. Moreover, among BD patients, the serum IL-2 and IL-6 levels were particularly high in those who maintained remission and received regular IFX treatments. Conclusion: We confirmed the long-term efficacy and tolerability of IFX in patients with BD-related uveitis. Our results indicate that complete BD may be less responsive to IFX and that the pretreatment serum cytokine profiles may be useful for predicting the long-term IFX therapy outcomes.

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Section: Discussionmentioning

confidence: 99%

Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease

et al. 2018

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“…The effect of anti TNF-α in BD has been investigated thoroughly, the beneficial effect of infliximab, adalimumab, and etanercept was reported [36,37]. In a multicenter observational study including 164 patients with BD with uveitis received infliximab for more than a year, infliximab was found reducing the number of ocular attacks per year [38]. Serious side effects were reported in 5 patients on adalimumab group and 17 on placebo Table 3: Summary of the studies that investigate using of anti TNF-α agents in Giant cell arteritis.…”

Section: Behçet's Diseasementioning

confidence: 99%

Use of Anti TNF-α Therapy in Systemic Vasculitis

Almteri¹,

Alshaiki²,

Hafiz³

et al. 2017

J Vasc

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There are several vascultic disorders still labeled as difficult-to-treat cases. Effective treatment for those patients is warranted to reduce the mortality and morbidity that resulting from these disorders. An extensive review for the literatures that addressed using of ant TNF-alpha in several vascultic disorders was conducted. Use of anti TNFalpha agents is a promising modality in several vascultic disorders. Despite lacking well-conducted randomized controlled trials, more open-label studies are required to examine in-depth the safety and efficacy of those agents.

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“…Hence, initial therapy with pulse dose IV steroids is recommended in patients with Bechet's who experience new onset orbital inflammation or myositis. With regard to maintenance therapy of orbital Bechet's, there is a paucity literature; however, good longterm control has been noted with anti-TNF agents, like infliximab [117][118][119][120], and more recently with interleukin(IL)-1 inhibitors, like Anakinra [121,122], in patients with systemic disease.…”

Section: Bechet's Diseasementioning

confidence: 99%