SAT0148 Short and Long-Term Biological Therapy in Refractory Uveitis of Behcet’S Syndrome. Multicenter Study of 108 Patients

Abstract

Objectives To assess response to biological therapy in uveitis associated to Behçet´s syndrome (BS) refractory to standard immunosuppressants (IS). Methods Study of 108 patients from 32 hospitals. All of them presented inadequate response to at least 1IS. Inflammation was evaluated according to SUN (Am J Ophthalmol 2005); macular thickness by optical coherence tomography (OCT). Results were expressed as mean±SD, or median [25t-75th(IQR)]. Comparisons were made between baseline and 1st week, 1st, 6th month, 1st, 2nd, 3rd and 4th year (Wilcoxon). Results We studied 108 patients/193 affected eyes (59M/49W); mean age 38.2±10.4 years (range 10-67). Before biologic onset they had received iv MethylP (32 cases), CyA (91), MTX (53) or AZA (62). Anti-TNF was 1st choice: infliximab (IFX)(65 cases) and adalimumab (ADA)(43); in monotherapy (22 cases) or in combination: CyA (49 cases), MTX (20), AZA (15), Micophenolate (1), or tacrolimus (1). In refractory or toxicity to 1st biologic was used; Golimumab (4 cases), Tocilizumab (1), RTX (1) and ETN (1). Anti-TNF follow-up was 35.4±20.2 months. Tyndall, vitritis and OCT showed a rapid and significant improvement at the 1st week. From biological onset to 2 years of follow-up patients showed an improvement of Tyndall from a median [IQR] of 1 [0-2] to 0 [0-0] (p<0.001), vitritis, 1 [0-2] to 0 [0-0] (p<0.001). At basal, 51 patients,(79 eyes) had macular thickening (OCT>250μ) and 31 (44 eyes) had cystoid macular edema (CME)(OCT>300μ). CME improved from 422.2±118.2 to 280.5±56.4 microns at 2 years (p<0.001). Conclusions Biological therapy, especially IFX and ADA, yields short and long-term efficacy in uveitis refractory to standard IS in BS. Disclosure of Interest None Declared

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.…”

“…The changes of CMT were evaluated and analyzed in five studies ( Al Rashidi et al., 2013 ; Bejerano et al., 2013 ; Calvo-Río et al., 2013 ; Calvo-Río et al., 2014 ; Domínguez Casas et al., 2017 ). The pooled results suggested that CMT decreased by 112.70 μm, with a 95% CI of 72.8–153 μm, indicating significant difference.…”

“…A total of 14 studies (Keino et al, 2011;Al Rashidi et al, 2013;Bejerano et al, 2013;Calvo-Rıó et al, 2013;Hamuryudan et al, 201011 0.9 0 0 (0) None Bejerano et al (2013) 63 2 1 1 (1.59) Miliary TB in 1 patient at month 1 after the onset of IFX. Calvo-Rı́o et al 2013108 2 NA NA NA Calvo-Rio et al 2014124 1 NA 3 (2.4) Minor side effects: mild infusion reactions and local reactions (pain and erythema).…”