Background Despite intensive immunosuppressive therapy, permanent loss of vision resulting from relapsing ocular inflammation occurs frequently in Behçet’s disease. Since tumor necrosis factor (TNF) have a pathogenic role in Behçet’s uveitis, the use of infliximab (a monoclonal antibody against TNF-α) have been suggested in resistant Behçet’s uveitis
Objectives We aim to evaluate the responsiveness of patients with severe uveitis associated with Behçet’s disease to infliximab.
Methods We retrospectively reviewed the medical charts of Behçet’s disease patients with severe uveitis treated with infliximab infusions.
Results Among 33 patients followed for Behçet’s uveitis in our internal medicine department, seven patients were treated with infliximab infusions. The mean age of these patients was 33.7 years (range 24-44 years), they were all men. Six patients had bilateral panuveitis and one patient had bilateral posterior uveitis. Retinal vasculitis was associated to uveitis in all patients. Three patients had neurological involvement in addition to ocular lesions, another patient had vascular involvement. The infliximab was given at a dose of 3mg/kg in weeks 0, 2, 6 than every 8 weeks. The number of infliximab infusions ranges from 5 to 22 infusions. Before receiving infliximab patients were treated with conventional immunosuppressive agents which includes cyclophosphamide, azathioprine and cyclosporine. Before the Infliximab infusions onset, 71% of patients had a visual acuity under than 1/10. One year after the infliximab onset this frequency decreased to 29%. The number of ocular relapses decreased after the infliximab onset and ranges from 0 to 4 flares. One patient had no more relapse after one year of infliximab treatment.
Conclusions The use of infliximab in the therapeutic regimen of Behçet’s uveitis had improved the visual prognosis of the ocular involvement of Behçet’s disease. The cost of infliximab could limit the use of this treatment in the management of Behçet’s uveitis.
Disclosure of Interest: None Declared
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