Effect of infliximab on sight-threatening panuveitis in Behcet's disease

Sfikakis, PP; Theodossiadis, P G; Katsiari, Christina G.; Kaklamanis, P; Markomichelakis, Nikos N.

doi:10.1016/s0140-6736(01)05497-6

Cited by 452 publications

(223 citation statements)

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“…Patients from Greece and Japan who had uveitis refractory to conventional treatment were studied in 2 open-label trials (21,22). In the series reported by Sfikakis et al (13,21), the number and type of previous systemic medications or their dosages were not uniform. In the study of 15 patients who received continuous infliximab therapy in a 32-week protocol, only 5 patients were receiving the combined regimen of azathioprine, cyclosporine, and prednisolone prior to enrollment (21).…”

Section: Discussionmentioning

confidence: 92%

“…Infliximab, with its documented potent antiinflammatory features in patients with rheumatoid arthritis or Crohn's disease, has been tried as such an option in selected patients with BD (13)(14)(15)(16)(17). Patients from Greece and Japan who had uveitis refractory to conventional treatment were studied in 2 open-label trials (21,22).…”

Section: Discussionmentioning

confidence: 99%

“…Infliximab, a recombinant chimeric monoclonal antibody specific for human TNF␣, which effectively binds and stabilizes both the soluble and membranous forms of TNF␣, has been shown to be an effective agent in the treatment of rheumatoid arthritis, Crohn's disease, and spondylarthropathies (10)(11)(12). Anti-TNF agents have also begun to be used as a new therapeutic approach in other inflammatory disorders, including BD, and early studies on the use of infliximab in Behçet's uveitis have shown remarkably beneficial results (13)(14)(15)(16)(17). Therefore, we conducted an open-label prospective trial to evaluate the efficacy of infliximab in patients with BD in whom uveitis was resistant to combination therapy with azathioprine, cyclosporine, and corticosteroids.…”

mentioning

confidence: 99%

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Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in behçet's disease: An open‐label trial

Tuğal-Tutkun¹,

Mudun²,

Urgancioğlu³

et al. 2005

Arthritis & Rheumatism

283

151

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Objective. To investigate the effect of infliximab on the frequency of uveitis attacks and the visual prognosis in male patients with Behçet's disease in whom uveitis was resistant to combination therapy with corticosteroids, azathioprine, and cyclosporine.Methods. The study group comprised patients who were receiving combination therapy but experienced at least 2 attacks of posterior uveitis/panuveitis or retinal vasculitis during the 6-month period prior to enrollment. Infliximab infusions (5 mg/kg) were administered at weeks 0, 2, 6, and 14. Weeks 0-22 were defined as the infusion period, and weeks 23-54 were defined as the observation period. Patients continued to receive azathioprine and corticosteroids, but cyclosporine was discontinued after the screening visit. The primary outcome measures were the absence of uveitis attacks during the infusion period (remission), and the absence of uveitis attacks throughout the study period (sustained remission).Results. Thirteen patients were enrolled in the study. Thirty-two uveitis attacks involving the posterior segment occurred during the previous-treatment period. During the infusion period, 4 patients (30.8%) remained attack-free, and 9 patients had a total of 13 uveitis attacks. Ten of these attacks (76.9%) occurred at either week 14 or week 22. One of 13 patients fulfilled the definition of sustained remission, and the remaining 12 patients had a total of 36 uveitis attacks during the observation period. The mean number of uveitis attacks and daily corticosteroid doses were significantly lower during the infusion period than during the previoustreatment period or the observation period. Although potential visual acuity was regained following infliximab infusion, this beneficial effect was not preserved until week 54. None of the patients experienced a serious adverse event.Conclusion. The results of this trial suggest that infliximab is effective in suppressing the occurrence of uveitis attacks, has a corticosteroid-sparing effect, and has favorable implications for the visual prognosis of patients with resistant Behçet's uveitis.Behçet's disease (BD) is a multisystem inflammatory disorder with a chronic, relapsing course. Patients with ocular involvement typically have bilateral nongranulomatous panuveitis and retinal vasculitis that involves all elements of the retinal vasculature (1). The course of the disease is characterized by recurrent, explosive attacks of uveitis followed by spontaneous remissions. The severity and frequency of these inflammatory episodes determine the extent of permanent damage to the intraocular structures and resultant visual loss. Permanent sequelae of posterior segment involvement include optic atrophy, maculopathy, sheathing and occlusion of retinal vessels, and diffuse atrophy and gliosis of the retina. Although the course of the disease shows individual variability, male patients have a younger age at disease onset, more severe disease, and

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in behçet's disease: An open‐label trial

Tuğal-Tutkun¹,

Mudun²,

Urgancioğlu³

et al. 2005

Arthritis & Rheumatism

283

151

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“…The use of inXiximab in BD was Wrst described in 2001 [14] and since then a number of case series and single reports have been published. Initial indications for treatment were sightthreatening uveitis and severe inXammatory gastrointestinal disease.…”

Section: Discussionmentioning

confidence: 99%

“…Case studies have indicated the eYcacy of inXiximab treatment of patients with BD in refractory ocular [14][15][16], neurological [17,18], mucocutaneous [19], and gastroenterological involvement [20,21].…”

Section: Introductionmentioning

confidence: 99%

One year study of efficacy and safety of infliximab in the treatment of patients with ocular and neurological Behçet’s disease refractory to standard immunosuppressive drugs

Giardina

Ferrante²,

Ciccia³

et al. 2009

Rheumatol Int

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The aim of the study was to assess the long-term eYcacy and safety of InXiximab therapy in the treatment of patients with Behçet's disease refractory to standard immunosuppressive agents. Twenty-one patients that did not respond to corticosteroids and to at least one immunosuppressant (cyclosporin, methotrexate, azathioprine, cyclophosphamide) for the presence of ocular and/or CNS involvement were enrolled. Eighteen patients completed the study up to 54 weeks. Stable doses of prednisone (<10 mg/day) were permitted, immunosuppressants were discontinued at least 4 weeks prior baseline visit. The patients received three infusions of 5 mg/kg InXiximab (at weeks 0, 2 and 6) and then infusions of 5 mg/kg InXiximab every 8 weeks. At each visit data on clinical symptoms, response to therapy and adverse events were collected. The primary outcome of interest was to assess the clinical eYcacy (total or partial recovery) of inXiximab. Secondary end points were to evaluate quality of life and to monitor the safety of the drug. Eighteen patients achieved a total remission. Two patients achieved a partial remission and relapsed after 3 months from discontinuation of therapy. InXiximab was well tolerated throughout the study. A case of non-Hodgkin lymphoma was observed within 6 months.Minor side eVects were headache, dizziness, tachycardia that regressed spontaneously and did not entail interruption. Anti-nuclear antibodies were not detected during the period of observation.

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Neutralizing Tumor Necrosis Factor Activity Leads to Remission in PatientsWith Refractory Noninfectious Posterior Uveitis

Murphy

Greiner²,

Plskova³

et al. 2004

Arch Ophthalmol

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Effect of infliximab on sight-threatening panuveitis in Behcet's disease

Cited by 452 publications

References 4 publications

Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in behçet's disease: An open‐label trial

Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in behçet's disease: An open‐label trial

One year study of efficacy and safety of infliximab in the treatment of patients with ocular and neurological Behçet’s disease refractory to standard immunosuppressive drugs

Neutralizing Tumor Necrosis Factor Activity Leads to Remission in PatientsWith Refractory Noninfectious Posterior Uveitis

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