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