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贝赫切特病相关性难治性葡萄膜炎患者接受英夫利昔单抗治疗的长期临床结局。

Long-term clinical outcomes in patients with refractory uveitis associated with Behçet disease treated with infliximab.

机构信息

Department of Ophthalmology, College of Medicine, King Saud University , Riyadh , Saudi Arabia.

出版信息

Ocul Immunol Inflamm. 2013 Dec;21(6):468-74. doi: 10.3109/09273948.2013.779727. Epub 2013 Jun 4.

Abstract

PURPOSE

To assess long-term efficacy and safety of infliximab for refractory Behçet disease (BD) uveitis and to evaluate the effect of withdrawal of infliximab after achieving long-term remission.

METHODS

Retrospective study of 19 patients.

RESULTS

Mean follow-up was 44.1 ± 36.5 months and mean number of infliximab infusions was 21.6 ± 14.6. At end of follow-up, there was significant improvement of visual acuity and reduction of central macular thickness. All patients achieved remission, 14 of whom were able to discontinue corticosteroids. Ten patients developed autoantibodies and 1 patient developed infusion reactions. Eight eyes underwent intraocular surgery without exacerbation of quiescent uveitis. After achieving complete remission, 5 patients discontinued infliximab and maintained remission during a mean of 24.6 ± 5.5 months.

CONCLUSIONS

Infliximab is effective and safe for long-term treatment for refractory BD uveitis. Repeated infusions are required to maintain long-term remission, which may be sustained despite withdrawal of infliximab. Induction of autoantibodies is common.

摘要

目的

评估英夫利昔单抗治疗难治性贝赫切特病(BD)葡萄膜炎的长期疗效和安全性,并评估达到长期缓解后停用英夫利昔单抗的效果。

方法

回顾性研究 19 例患者。

结果

平均随访时间为 44.1 ± 36.5 个月,平均英夫利昔单抗输注次数为 21.6 ± 14.6。随访结束时,视力明显改善,中央黄斑厚度降低。所有患者均达到缓解,其中 14 例能够停用皮质类固醇。10 例患者出现自身抗体,1 例患者出现输注反应。8 只眼行眼内手术,静止性葡萄膜炎无加重。完全缓解后,5 例患者停用英夫利昔单抗,平均缓解 24.6 ± 5.5 个月。

结论

英夫利昔单抗治疗难治性 BD 葡萄膜炎长期有效且安全。需要反复输注以维持长期缓解,尽管停用英夫利昔单抗,但缓解仍可持续。诱导自身抗体很常见。

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