Abstract
To determine the efficacy of infliximab treatment in refractory posterior uveitis in Behçet’s disease after withdrawal of infusions. Four patients with posterior uveitis secondary to Behçet’s disease were treated with infliximab until complete remission and were followed after withdrawal of infusions. Intra-ocular inflammation was assessed using the binocular indirect ophthalmoscopy score, best-corrected visual acuity (BCVA) and foveal thickness measured by optic coherence tomography (OCT). All the patients included in the study were treated with infliximab for a minimum of 12 months and were in complete remission. None of the patients were taking steroids or immunosuppressants. Main follow-up after withdrawal of infusions was 7.5 months. Two out of four patients (50%) maintained complete remission of posterior uveitis. BCVA was stable in seven eyes. OCT showed worsening in macular edema in the two eyes of the patients with reactivation. Infliximab is an efficient long-term treatment for refractory posterior uveitis. Repeated infusions are required to maintain long-term remission which may be sustained on discontinuation of the drug.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Scallon BJ, Moore MA, Trinh H, Knight DM, Ghrayeb J (1995) Chimeric anti-TNF-alpha monoclonal antibody cA2 binds recombinant transmembrane TNF-alpha and activates immune effector functions. Cytokine 7:251–259
Sfikafis PP, Theodossiadis PG, Katsiari CG, Kahlamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuevitis in Behçet’s disease. Lancet 358:295–296
Tugal-Tutkun I, Mudun A, Urgancioglu M et al (2005) Efficacy of inflximab in the treatment of uveitis that is resistant to treatment with combination of azathioprine, cyclosporine and corticosteroid in Behçet disease; an open-label trial. Arthritis Rheum 52:2478–2484
Munoz-Hernandez S, Hidalgo V, Fernández-Melón J, Schlincker A, Martin-Mola E (2001) Effect of infliximab on threatening panuveitis in Behçet’s disease. Lancet 358:1644
Benitez-del-Castillo JM, Martinez-de-la-Casa JM, Pato-Cour E et al (2005) Long-term treatment of refractory posterior uveitis with anti-TNF-α (infliximab). Eye 19:841–845
Hale S, Lightman S (2006) Anti-TNF therapies in the management of acute and chronic uveitis. Cytokine 33:231–237
Galor A, Perez VL, Hammel JP, Lowder CY (2006) Differential effectiveness of etanercept and infliximab in the treatment of ocular inflammation. Ophthalmology 113:2317–2323
Ohno S, Nakamura S, Hori S et al (2004) Efficacy, safety and pharmacokinetics of multiple administration of infliximab in Behçet’s disease with refractory uveoretinitis. J Rheumatol 31:1362–1368
Accorinti M, Pirraglia MP, Paroli MP, Priori R, Conti F, Pivetti P (2007) Infliximab treatment for ocular and extraocular manifestations of Behçet’s disease. Jpn J Ophthalmol 51:191–196
Tognon S, Graziani G, Marcolongo R (2005) Anti-TNG-alpha therapy in seven patients with Behçet’s uveitis: advantages and controversial aspects. Ann NY Acad Sci 1051:506–514
Tabbara KF, Al-Hemidan AI (2008) Infliximab effects compared to conventional therapy in the management of retinal vasculitis in Behçet disease. Am J Ophthalmol 146:845–850
Nicoli L, Nannini C, Benucci M, Chindamo D et al (2007) Long-term efficacy of infliximab in refractory posterior uveitis of Behçet’s disease: a 24-month follow-up study. Rheumatology 46:1161–1164
van der Bijl AE, Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Ten Wolde S, Han KH, van Krugten MV, Allaart CF, Breedveld FC, Dijkmans BA (2007) Infliximab and methotrexate as induction therapy in patients with early rheumatoid arthritis. Arthritis Rheum 56:2129–2134
Caviglia R, Ribolsi M, Rizi M, Emerenziati S, Annunziata ML, Cicala M (2007) Maintenance of remission with infliximab in inflammatory bowel disease: effficacy and safety long-term follow-up. World J Gastroenterol 13:5238–5244
Quinn MA, Conaghan PG, O’Connor PJ, Karim Z, Greenstein A, Brown A, Brown C, Fraser A, Jarret S, Emery P (2005) Very early treatment with infliximab in addition to methotrexate in early, poor-prognosis rheumatoid arthritis reduces magnetic resonance imaging evidence of synovitis and damage, with sustained benefit after infliximab withdrawal: results from a twelve-month randomized, double-blind, placebo-controlled trial. Arthritis Rheum 52:27–35
Abu El-Asrar AM, Abboud EB, Aldibhi H, Al-Arfaj A (2005) Long-term safety and efficacy of infliximab therapy in refractory uveitis due to Behçet disease. Int Ophthalmol 26:83–92
Markomichelakis NN, Theodossiadis PG, Pantelia E, Papaefthimiou S, Theodossiadis GP, Sfikakis PP (2004) Infliximab for chronic cystoid macular edema associated with uveitis. Am J Ophthalmol 138:648–650
Diaz-Llopis M, García-Delpech S, Salom D et al (2008) Adalimumab therapy for refractory uveitis: a pilot study. J Ocul Pharmacol Ther 24:351–361
Mushtaq B, Sabed T, Situnayake RD, Murria PI (2007) Adalimumab for sight-threating uveitis in Behçet’s disease. Eye 21:824–825
van Laar JAM, Mossotten T, van Daele PLA, Jamnitski A, Baarsma GS, van Hagen PM (2007) Adalimumab: a new modality for Behçet’s disease? Ann Rheum Dis 66:565–566
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Adán, A., Hernandez, V., Ortiz, S. et al. Effects of infliximab in the treatment of refractory posterior uveitis of Behçet’s disease after withdrawal of infusions. Int Ophthalmol 30, 577–581 (2010). https://doi.org/10.1007/s10792-010-9372-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-010-9372-1