Infliximab for the Treatment of Refractory Adamantiades-Behçet Disease with Articular, Intestinal, Cerebral and Ocular Involvement

Donghi, Davide; Mainetti, Carlo

doi:10.1159/000277928

Cited by 15 publications

(9 citation statements)

References 37 publications

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“…27 Another patient was also reported to have rapid resolution of BD retinal vasculitis when treated with prednisone and infliximab (in addition to azathioprine that he was already on) and sustained remission, despite tapering to a low dose of prednisone, while continuing azathioprine and receiving infliximab infusions every 6, 7, and then 8 weeks. 28 A group of 4 patients with sightthreatening, recurrent posterior uveitis due to BD treated in Spain all had complete remission during treatment; 2 had sustained remission for at least 6 months after discontinuing therapy, but the other 2 relapsed (4 and 6 months after therapy ended). 29 In a larger and more recent series, masked observers graded background and disc vascular leakage on fluorescein angiograms from 14 patients before infliximab treatment and during infliximab treatment; clinical outcomes were also reported.…”

Section: Seminars In Ophthalmologymentioning

confidence: 99%

The Use of Biologic Agents in the Treatment of Ocular Manifestations of Behcet’s Disease

Benitah

Sobrin

Papaliodis

2011

Seminars in Ophthalmology

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Behçet's Disease (BD) is a multisystem inflammatory disorder of uncertain etiology with a variety of potential manifestations throughout the body, and its ocular complications are some of its most devastating. Treatment with immunosuppressive agents has improved outcomes, but many patients suffer from disease that responds poorly to conventional therapies. Because of this, therapy with a variety of biological response modifiers has been employed. The earliest was interferon-α, and a multitude of reports have described its benefits for the uveitis associated with Behçet's Disease. Many patients enjoy durable remissions of their ocular inflammatory disease even after discontinuation of therapy, but side-effects are almost universal and some can be dangerous. Of the newer biological response modifiers, infliximab, a monoclonal antibody to TNF-α, has been most extensively studied. It is reported to be rapidly effective in many cases of Behçet's Disease uveitis, though with conflicting data as to the ability to induce durable remission after cessation of treatment. Side-effects are relatively rare, but may be serious. Several reports have been published on the use of other biologic agents, including adalimumab (a humanized antibody to TNF-α), etanercept (a molecule that resembles the TNF-α receptor), and rituximab (an antibody to CD20 that depletes the body of CD20-positive B cells). Of the three of these, adalimumab has the most promising initial evidence, etanercept has very few positive reports in patients with BD uveitis (and is likely ineffective in uveitis in general), and rituximab is lacking data. Although randomized controlled trials are almost completely lacking, currently available evidence is promising that biologic agents can prove an invaluable addition to the armamentarium of the practitioner treating patients with BD uveitis.

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Section: Seminars In Ophthalmologymentioning

confidence: 99%

The Use of Biologic Agents in the Treatment of Ocular Manifestations of Behcet’s Disease

Benitah

Sobrin

Papaliodis

2011

Seminars in Ophthalmology

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“…In a control study, the number of relapses was signifi cantly less in the infl iximab treatment group than the conventional therapy group that included cyclosporine, azathioprine, and an oral corticosteroid [ 60 , 92 ]. Moreover, clinical studies of infl iximab for BD have shown it to be rapidly effective not only for symptoms of ocular BD [ 49 , 50 , 60 , 91 -93 , 115 ] but also other systemic symptoms, such as oral aphthous ulcers [ 49 , 94 ], genital ulcers [ 95 -97 ], skin lesions [ 49 ], arthritis [ 97 ], gastrointestinal lesion [ 97 , 98 ], and CNS involvement [ 97 , 99 , 100 ].…”

Section: Anti-tnf-α Biological Agentsmentioning

confidence: 99%

Ocular Involvement

Kaburaki¹

2014

Behçet's Disease

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Ocular involvement in Behçet's disease (BD) is characterized by recurrent explosive attacks of intraocular infl ammation, including iridocyclitis, hypopyon, chorioretinitis, retinal vasculitis, retinal vein occlusion, optic neuritis, retinal neovascularization, and vitreous hemorrhage, while uveitis is more common in young males. Retinal disease, especially occlusive retinal vasculitis, is one of the most serious complications and can lead to permanent retinal damage and visual impairment. Colchicine, cyclosporine, corticosteroid, azathioprine, and other immunosuppressive agents are generally used to manage ocular infl ammatory attacks. Recently, antitumor necrosis factor-α agents have been shown to dramatically reduce the frequency of ocular attacks in BD patients with refractory uveoretinitis, indicating it as a promising therapy for ocular BD.

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“…Some examples are summarized in table 2 . Thus, in patients with supposed auto-inflammatory mechanism, IL-1 inhibitors are a logical treatment as an increase in IL-1 release by monocyte-macrophage is probably the key pathogenetic mechanism; anti-TNF drugs were also successfully used in some patients [16,17] .…”

Section: Il-1 Inhibition In Cryopyrin-mentioning

confidence: 99%

IL-1 Inhibition in Cryopyrin-Associated Periodic Syndrome and Beyond: A Million Dollar Question about the Injection Schedule of Biotherapies

Lipsker

Lachmann

2011

Dermatology

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Infliximab for the Treatment of Refractory Adamantiades-Behçet Disease with Articular, Intestinal, Cerebral and Ocular Involvement

Cited by 15 publications

References 37 publications

The Use of Biologic Agents in the Treatment of Ocular Manifestations of Behcet’s Disease

The Use of Biologic Agents in the Treatment of Ocular Manifestations of Behcet’s Disease

Ocular Involvement

IL-1 Inhibition in Cryopyrin-Associated Periodic Syndrome and Beyond: A Million Dollar Question about the Injection Schedule of Biotherapies

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