Multicenter study of infliximab for refractory uveoretinitis in Behçet disease.

OBJECTIVE

To describe the effects of infliximab on refractory uveoretinitis in patients with Behçet disease during the first year of treatment.

METHODS

Data were collected prospectively at 8 tertiary uveitis centers. Safety was analyzed in 63 patients. Efficacy was analyzed in 50 patients, after exclusion of those who had received infliximab for various reasons before the study.

RESULTS

Eighty-nine percent (56 of 63) of the patients were male, with 70% (44 of 63) of the patients aged 25 to 44 years. The safety analysis demonstrated that 34 episodes of adverse effects occurred in 46% (29 of 63) of patients during 1 year, including 3 episodes of infusion reactions. No adverse effects were deemed serious. The efficacy analysis at 1 year showed that uveoretinitis had improved in 69% (33 of 48), had improved somewhat in 23% (11 of 48), was unchanged in 8% (4 of 48), and had worsened in no patients. The mean number of ocular attacks per 6-month period decreased from 2.66 at baseline to 0.44 during months 1 through 6 of infliximab therapy and to 0.79 during months 7 through 12. Forty-four percent (21 of 48) of patients had no ocular attacks during the 1-year period. Efficacy was best for patients with uveoretinitis duration of less than 5 years. The mean best-corrected visual acuity improved logarithm of the minimum angle of resolution from 0.736 at the first infliximab infusion to 0.616 at the end of 1 year (P = .01).

CONCLUSIONS

Infliximab treatment for Behçet disease uveoretinitis was well tolerated, with nonserious adverse effects occurring in about half of the patients. At the end of 1 year, uveoretinitis had improved or improved somewhat in 92% (44 of 48) of patients, accompanied by improvement in the mean visual acuity.