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THU0326 Short and long-term follow-up with adalimumad in refractory uveitis associated to behÇet's disease. multicenter study of 74 patients
  1. L Domínguez-Casas1,
  2. V Calvo-Río1,
  3. E Beltrán2,
  4. J S-Bursόn3,
  5. M Mesquida4,
  6. A Adán4,
  7. M Hernandez4,
  8. M H-Grafella5,
  9. E V-Pascual6,
  10. L M-Costa7,
  11. A Sellas8,
  12. M Cordero-Coma9,
  13. M Díaz-Llopis10,
  14. R Gallego10,
  15. D Salom10,
  16. J G-Serrano11,
  17. N Ortego12,
  18. J Herreras13,
  19. A G-Aparicio14,
  20. O Maíz15,
  21. A Blanco15,
  22. I Torre16,
  23. D Díaz-Valle17,
  24. E Pato17,
  25. E Aurrecoechea18,
  26. M Caracuel19,
  27. F Gamero20,
  28. E Minguez21,
  29. C Carrasco22,
  30. A Olive23,
  31. J Vázquez24,
  32. O R-Moreno25,
  33. J Manero25,
  34. S Muñoz26,
  35. M Gandia27,
  36. E Rubio-Romero28,
  37. F Toyos-SMiera29,
  38. F Lόpez-Longo30,
  39. J Nolla31,
  40. M Revenga32,
  41. N Vegas-Revenga1,
  42. C Fernández-Díaz1,
  43. R Demetrio-Pablo1,
  44. M González-Gay1,
  45. R Blanco1
  1. 1HUMV, Santander
  2. 2H Mar, Barcelona
  3. 3H Valme, Sevilla
  4. 4H Clinic, Barcelona
  5. 5H General
  6. 6H, Valencia
  7. 7H Peset, Zaragoza
  8. 8H Vall d'Hebron, Barcelona
  9. 9H, Leόn
  10. 10H FE, Valencia
  11. 11H Cecilio
  12. 12H Cecilio, Granada
  13. 13IOBA, Valladolid
  14. 14H, Toledo
  15. 15H, Donostia
  16. 16H Basurto, Bilbao
  17. 17HS Carlos, Madrid
  18. 18H, Torrelavega
  19. 19H, Cόrdoba
  20. 20H, Cáceres
  21. 21H Clínico, Zaragoza
  22. 22H, Mérida
  23. 23H G Trias, Badalona
  24. 24H, Ferrol
  25. 25H Servet, Zaragoza
  26. 26HU Infanta Sofía, San Sebastian de los Reyes
  27. 27H P Mar, Cádiz
  28. 28H V Rocío
  29. 29H V Macarena, Sevilla
  30. 30H G Marañon, Madrid
  31. 31H Bellvitge, Barcelona
  32. 32H R Cajal, Madrid, Spain

Abstract

Objectives To evaluate the efficacy of adalimumab (ADA) in short and long term follow-up in refractory uveitis of Behçet's disease (BD)

Methods Multicenter study. Ocular inflammation was evaluated according to “SUN working Group” (Am J Ophthalmol 2005;140:509–516), and the macular thickening with OCT. A comparison was carried out between baseline, and follow-up visits. Results are expressed as mean±SD or median [IQR]. Continuous variables were compared with Wilcoxon test.

Results We studied 74 patients/132 affected eyes (39M/35W); mean age 38.7±11.3. The ocular pattern was panuveitis (n=45), posterior uveitis (n=14), anterior uveitis (n=14) and intermediate uveitis (n=1). Before ADA, systemic treatment with corticosteroids, iv metilprednisolone (n=23), Cyclosporin A (58), azathioprine (33), metotrexate (31) and other drugs (28) was used. The dose of ADA was 40 mg/2 weeks/ sc in monotherapy (n=22) or combined (n=52). Most patients showed a rapid and progressive improvement (TABLE). The 24 patients (37 affected eyes) with CME showed a significant improvement.

ADA was optimized in 23 (31.1%) that were in remission for 15.3±9 months. Interval of administration was increased to 3 (n=6), 4 (13), 5 (1), 6 (1) and 8 weeks. After a mean follow-up of 13.0±9.7 months after optimization, 21 patients were stable and 2 had a severe flare. In 4 patients ADA was stopped after 35.2±9.3 months in remission. The main adverse effects observed were lymphoma (n=1), pneumonia (1), and 2° bacteriemia by E. Coli (1)

Conclusions ADA was effective in short and long-term follow-up in refractory uveitis associated to BD. Optimization or even suspension of ADA is possible.

Disclosure of Interest None declared

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