Objectives To compare the efficacy and safety of infliximab (IFX) versus adalimumab (ADA) as first biologic drug in refractory uveitis due to Behçet's disease (BD) for 1-year period.
Methods Multicenter study of 125 patients with BD's uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. IFX (3-5 mg/kg at 0, 2, and 6 weeks and then every 4-8 weeks) was used in 75 cases and ADA (usually 40 mg every 2 weeks) in 50 cases. The main comparative outcome measures were improvement of visual acuity (VA) (at least 20%), complete inactivity of anterior chamber inflammation, vitritis, and retinal vasculitis as well as macular thickness <250 microns. A bivariate and logistic regression analysis was performed for every previous outcome between ADA vs IFX (SPSS20.0 package).
Results 125 patients (223 affected eyes) were studied. No statistically significant differences at baseline were observed between IFX vs ADA groups in sex (♂/♀; 41/34 vs 29/21; p=0,71), mean age (39,2±9.39 vs 36,14±12,7; p=0.12), HLA B51 positive (75% vs 75%), uveitis duration before anti TNF-α onset (median [IQR]; 36 [12-71] vs 24 months [12-60]; p=0.4), VA (0,47±0,26 vs 0,52±0,27; p=0,29), anterior chamber cells (median [IQR]; 0,5 [0-2] vs 1,5 [0-2]; p=0,2), retinal vasculitis (73,2% vs 75%; p=0,95); macular thickness (285,90±90,15 vs 312,02±106,57; p=0,25), combined treatment (82.7% vs 77,6%; p=0.481), basal degrees of immunosuppression (mean ± SD; 11.35±5.67 vs 9.65±4.68; p=0.09).
There were a better non-statistical respond with ADA in improvement of VA, complete inactivity of anterior chamber inflammation, and macular thickness <250 microns, and with IFX in inactivity of vitritis, and retinal vasculitis (Table)
Conclusions Our study suggests that ADA and IFX do not show statistical differences at one year in refractory uveitis of BD.
Disclosure of Interest None declared
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