Background Infliximab (IFX) is highly effective for uveitis in Behcet’s disease (BD), but the therapy does not completely suppress ocular manifestations.
Objectives This study determined what factors are associated with ocular attacks during the IFX therapy.
Methods We retrospectively examined clinical courses of 19 BD patients (female 2+1, male 15+1, age 39.9±12.1 yo patients are only for the analysis of he safety of IFX) who received IFX due to uveitis. In the original regimen, IFX (5mg/kg) was given at 0, 2, 6 week, and thereafter every 8 weeks, but the intervals were shortened after major ocular attacks occurred. Mean duration was 5.7±5.8 years from the disease onset to initiation of infliximab therapy. Before the infiliximab therapy, 16 patients had received colchicines and 7 patients had cyclosporine A. Duration of IFX was 29.9±14.8 months (7 to 60 months, 5 to 51 times). IFX therapy was discontinued in two patients by infusion reaction. The infusions were suspended one or two week in 2 patients because of infection including infectious mononucleosis by cytomegalovirus.
Results Visual acuity were improved in 18 eyes, unchanged in 7 eyes, and deteriorated in 5 eyes, (except blind eyes.) Frequency of ocular attacks was 2.6±2.1/6 month before and during the IFX therapy, while that was reduced to 0.41 + 0.49/6 months. During the therapy, total 35 ocular attacks occurred at 5.28±1.87 weeks after the last infusion, 1.53±1.59 weeks before the next expected infusion. After ocular attacks, the infusion interval was shortened from 5 to 7 weeks in 8 patients. Treatment with IFX is effective, safety and tolerable in BD patients with uveitis. Ocular attacks were significantly suppressed, resulting in improvement of visual acuity. However, the attacks were accumulated in the last 2 weeks of infusion interval.
Conclusions It is hard to predict responsiveness to IFX therapy based on the pre-therapeutic clinical features.
Disclosure of Interest None Declared