Efficacy of Infliximab in Patients with Refractory Uveitis Associated with Behcet Disease
|Nilüfer YalçÄ±ndaÄ F1, Özge YanÄ±k1* and NurÅen Düzgün2|
|1Ankara University, Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey|
|2Ankara University, Faculty of Medicine, Department of Internal Medicine-Rheumatology, Ankara, Turkey|
|Corresponding Author :||Özge YanÄ±k, MD
Ankara University Faculty of Medicine
Department of Ophthalmology
Mamak Cad. Dikimevi, Ankara 06100 Turkey
Tel: +90 506 736 15 99
Fax: +90 312 363 80 82
E-mail: [email protected]
|Received: October 08, 2013; Accepted: January 07, 2014; Published: January 17, 2014|
|Citation: YalçÄ±ndaÄ FN, YanÄ±k Ö, Düzgün N (2014) Efficacy of Infliximab in Patients with Refractory Uveitis Associated with Behçet Disease. J Clin Exp Ophthalmol 5:319. doi:10.4172/2155-9570.1000319|
|Copyright: © 2014 YalçÄ±ndaÄ FN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Ocular involvement in Behçet disease is responsible for severe morbidity by causing nongranulomatous panuveitis and retinal vasculitis. In some cases, recurrent attacks cannot be controlled by conventional immunosuppressives and corticosteroid or interferon. The aim of this study is to investigate the efficacy of infliximab treatment in patients with refractory uveitis associated with Behçet disease.
Methods: Nine patients with Behçet disease related uveitis were included in the study. Uveitis had been refractory to treatment with either a combination of cyclosporine-A, azathioprine, and corticosteroid or interferon α-2a monotherapy in all patients. Patients received infliximab infusions (5 mg/kg) at weeks 0, 2, 6, and every 8 weeks thereafter. In patients receiving interferon α-2a at the time of initiation of infliximab therapy, interferon was ceased before starting infliximab. We evaluated visual acuity, ocular inflammatory attacks, and adverse effects.
Results: The Patients consist of seven men and two women; their ages ranging from 28 to 49 years. The mean follow-up after initiating infliximab therapy was 14.4 months. Four of the patients had no ocular inflammatory attacks during follow-up. Two of the remaining five patients developed a mild anterior uveitis only once after the start of infliximab infusions. Three of the patients had a mild panuveitis attack 2-4 months after the initiation of infliximab therapy. Best corrected visual acuity (BCVA) improved at least 2 lines in 6 (33.3%) eyes, from no light perception to hand motion in one eye, and from light perception to hand motion in another eye. BCVA remained stable in 9 (50%) eyes. In one patient, infliximab treatment was terminated owing to HPV+genital warts at 8th month of therapy. No other adverse effects were noticed apart from temporary infusion reaction and urticaria-like rash.
Conclusions: With a follow-up period ranging from seven to thirty three (7-33) months, infliximab was effective and well tolerated in refractory Behçet uveitis.