ISSN 2147-9720 | E-ISSN 2148-4279
Original Article
Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease
1 Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan  
2 Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan  
3 Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, Japan  
4 Clinical Education Center, Kyushu University Hospital, Fukuoka, Japan  
5 Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan;Clinical Education Center, Kyushu University Hospital, Fukuoka, Japan  
Eur J Rheumatol 2018; 5: 9-15
DOI: 10.5152/eurjrheum.2017.17068
Key Words: Behçet’s disease, infliximab, predictive factor, uveitis
Abstract

 

Objective: To assess the long-term efficacy and safety of infliximab (IFX) treatment for refractory uveitis associated with Behçet’s disease (BD) and to identify predictors of long-term IFX therapy outcomes.

 

Methods: We retrospectively studied 44 consecutive BD patients with uveitis who were started on IFX therapy and analyzed the efficacy and safety of IFX and the treatment continuation rate. To determine predictors of IFX responsiveness, we analyzed the clinical characteristics of the patients who received regular maintenance therapy and those who required treatment intensification. The serum cytokine levels prior to IFX were measured through the Bio-Plex human cytokine assays.

 

Results: IFX significantly reduced the frequency of ocular attacks and improved the visual acuity of patients with BD-related uveitis. However, approximately half of the patients required dose escalations, necessitating a shortening of the intervals between IFX infusions due to loss of efficacy during the 5-year treatment. The frequency of ocular attacks was significantly higher in patients with complete BD than in patients with incomplete BD. A multiplex cytokine analysis revealed that patients with BD-related uveitis exhibited increased serum IL-2, IL-6, IL-8, and MCP-1 levels. Moreover, among BD patients, the serum IL-2 and IL-6 levels were particularly high in those who maintained remission and received regular IFX treatments.

 

Conclusion: We confirmed the long-term efficacy and tolerability of IFX in patients with BD-related uveitis. Our results indicate that complete BD may be less responsive to IFX and that the pretreatment serum cytokine profiles may be useful for predicting the long-term IFX therapy outcomes.

 

Cite this article as: Ueda S, Akahoshi M, Takeda A, Inoue Y, Omoto A, Ayano M., et al. Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease. Eur J Rheumatol 2018; 5: 9-15.

Key Words
Authors
All
Author’s Corner
Survey
AVES | Copyright © 2018 Medical Research and Education Association | Latest Update: 02.04.2018