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- Title
Infliximab Treatment for Ocular and Extraocular Manifestations of Behçet's Disease.
- Authors
Massimo Accorinti; Maria Pia Pirraglia; Maria Pia Paroli; Roberta Priori; Fabrizio Conti; Paola Pivetti-Pezzi
- Abstract
Abstract Purpose To assess the efficacy and safety of infliximab in the treatment of sight-threatening uveitis and extraocular manifestations in patients with Behet''s disease. Methods Twelve patients with Behet''s disease and uveitis were treated with infliximab after unsuccessful therapy with other immunosuppressive drugs. The main outcome measures were as follows: the number of uveitis relapses, the number of Behet''s disease-related extraocular lesions, and the amount of corticosteroids administered during the treatment as well as during an equal prior period of time while the patients were on other immunosuppressive agents. Visual acuity was recorded at the beginning of infliximab therapy and at the end of follow-up, and was defined as stable if it did not change from baseline, increased if it showed at least one line of improvement from baseline, and decreased if it showed at least a one line decrease from baseline. Results During an average follow-up of 16.67 7.63 months (median, 15 months), 11 patients (91.6%) showed a reduction in the number of ocular relapses (relapse/month, from 0.35 0.17 to 0.12 0.17, P n = 11) who were taking corticosteroids before infliximab were able to reduce the amount of corticosteroids taken daily during infliximab treatment (from 24.33 10.84 mg/prednisone per day to 8.97 6.81 mg/prednisone per day, P P = 0.039). One patient, who had to stop treatment 2 months after starting because of the onset of pulmonary tuberculosis, showed the same number of relapses during infliximab treatment but was able to reduce the mean daily corticosteroid dose. Visual acuity increased by one or more lines in three eyes (12.5%) and remained unchanged in 87.5% of the eyes. Infliximab-related side effects appeared in four patients (33.3%). Conclusions Infliximab was effective in the treatment of uveitis in these Behet''s disease patients, significantly reducing the number of ocular relapses and making possible a significant reduction in the daily dose of corticosteroids administered. Extraocular manifestations of Behet''s disease were also controlled by infliximab. Nevertheless, side effects were not uncommon, and an extensive study of systemic conditions before infliximab administration had to be carried out to exclude systemic infection, particularly prior tuberculosis. Jpn J Ophthalmol 2007;51:191–196 Japanese Ophthalmological Society 2007
- Subjects
UVEITIS; INFLIXIMAB; ADRENOCORTICAL hormones; DRUG dosage; IMMUNOSUPPRESSIVE agents
- Publication
Japanese Journal of Ophthalmology, 2007, Vol 51, Issue 3, p191
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-006-0425-y