<p>Long-term efficacy and safety of infliximab and cyclosporine combination therapy for refractory uveoretinitis in Beh&ccedil;et&rsquo;s disease</p>

Abstract

This study aimed to evaluate the long-term efficacy and safety of infliximab (IFX) and cyclosporine (CsA) combination therapy for refractory uveoretinitis in Behçet's disease (BD). Patients and methods: The study involved a retrospective review of the medical records of 11 patients with Behçet's uveoretinitis refractory to conventional treatment who had been treated with IFX+CsA combination therapy. The frequency of ocular inflammatory attacks and a Behçet's disease ocular attack score 24 (BOS24) were used as indices for the evaluation of efficacy during each 6-month period prior to and following initiation of therapy. For the assessment of safety, adverse events (AEs) were recorded throughout the treatment period. Results: The patients had received IFX+CsA combination therapy for 5.6±2.3 years. The frequency of ocular attacks per 6-month period decreased markedly from 2.9±1.6 during the baseline period to 0.6±0.9 during months 1-6, 0.5±0.9 during months 7-12, 0.3±0.5 during months 13-18, 0.3±0.7 during months 19-24, and 0.0±0.0 thereafter (P=0.003). The BOS24 score per ocular attack significantly decreased from 5.2±2.4 during the baseline period to 1.5±2.1 during months 1-6, 1.7±3.1 during months 7-12, 1.6±2.9 during months 13-18, and 0.4±1.0 during months 19-24 (P=0.002). No serious AEs were observed, with the exception of urinary tract infection and cataract progression. Two patients exhibited transient elevation of the serum creatinine level, which was normalized following a reduction in the dose of CsA. Conclusion: For refractory Behçet's uveoretinitis, IFX+CsA combination therapy offers a promising treatment option as it appears to have an acceptable safety profile and can reduce the frequency and severity of ocular inflammatory attacks over a long period of time.

Effectiveness and Safety of Anti-Tumor Necrosis Factor-Alpha Agents Treatment in Behcets’ Disease-Associated Uveitis: A Systematic Review and Meta-Analysis

“…The characteristics of these studies ( Bawazeer et al., 2010 ; Keino et al., 2011 ; Cantini et al., 2012 ; Okada et al., 2012 ; Al Rashidi et al., 2013 ; Bejerano et al., 2013 ; Calvo-Río et al., 2013 ; Hamuryudan et al., 2013 ; Mesquida et al., 2013 ; Calvo-Río et al., 2014 ; Interlandi et al., 2014 ; Takeuchi et al., 2014 ; Domínguez Casas et al., 2017 ; Fabiani et al., 2017 ; Degirmenci et al., 2018 ; El Garf et al., 2018 ; Martín-Varillas et al., 2018 ; Katsuyama et al., 2019 ; Yalcindag and Kose, 2019 ) were described in Table 1 and Supplementary Table 1 . The 18 articles comprised 968 patients in total and the number of patients in each study ranged from 11 to 164.…”

“…Pneumonia in 1 patient and depression in 1 patient. Interlandi et al (2014) 12 1.75 0 0 (0) None Katsuyama et al (2019) 11 2 4 0 (0) Urinary tract infection in 1 patient and significant cataract progression in 1 patient. Two patients exhibited transient elevation of serum creatinine levels.…”

“…2013; Mesquida et al, 2013;Calvo-Rıó et al, 2014;Takeuchi et al, 2014;Domıńguez Casas et al, 2017;Fabiani et al, 2017;El Garf et al, 2018;Martıń-Varillas et al, 2018;Katsuyama et al, 2019;Yalcindag and Kose, 2019) included safety information with more than 109 patients ( Table 3). According to the available data, 22 patients (2.62%) experienced severe AEs.…”

Comparative effectiveness of various immunosuppressive therapy regimens for uveitis in patients with Behçet’s disease

“…Таким образом, оба препарата эффективны у больных ББ с увеитом, и выбор для конкретного пациента зависит, как правило, от переносимости, предпочтений врача и лекарственного обеспечения. Необходимо отметить, что до настоящего времени практически все исследования эффективности ГИБП в отношении увеита при ББ не относятся к РКИ [25], и в них, за исключением отдельных работ японских [8,26,27] и иранских [28] авторов, не использовались количественные индексы оценки активности увеита.…”

Evaluation of disease activity in uveoretinitis associated with Behçet’s disease

“…Our previous study has shown that infliximab therapy with low-dose cyclosporine is effective in a long-term sustained manner over 4 years of treatment in ocular Behçet's disease [43]. Recently, Katsuyama and colleagues have revealed that infliximab plus cyclosporine combination therapy is welltolerated and can reduce the frequency of ocular attacks over a long period of time without loss of response to infliximab plus cyclosporine combination therapy [44]. On the other hand, Fabiani and colleagues have demonstrated that concomitant immunosuppressive treatment does not affect the infliximab or adalimumab retention rate in ocular Behçet's disease [38,40].…”