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贝赫切特葡萄膜炎患者停用英夫利昔单抗治疗后的临床病程。

Clinical course of patients with Behçet's uveitis following discontinuation of infliximab therapy.

机构信息

Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo, Tokyo, 113-8677, Japan,

出版信息

Jpn J Ophthalmol. 2014 Jan;58(1):75-80. doi: 10.1007/s10384-013-0283-3. Epub 2013 Oct 16.

Abstract

PURPOSE

To investigate the clinical course of Behçet's uveitis patients following discontinuation of infliximab therapy.

METHODS

This retrospective chart review study examined Behçet's disease patients who received infliximab treatment between 2000 and 2012. Medical records of patients whose infliximab treatment was discontinued were reviewed, with special focus on the frequency of uveitis attacks in the period before initiation, during treatment and after cessation of the infliximab therapy. Mean visual acuities were evaluated for each treatment period.

RESULTS

Out of the 43 patients treated with infliximab at our uveitis clinic, ten were discontinued due to adverse events or inefficiency. Data for seven patients followed for more than 12 months before initiation and after cessation of infliximab were analyzed. Frequency of acute uveitis attacks was 7.43 per 12 months before initiation of infliximab, 2.86 during treatment and 0.57 after cessation. A statistically higher frequency of uveitis attacks was observed before initiation of infliximab compared to during (p < 0.05) and after cessation of treatment (p < 0.05). There was no statistical significance observed between the period during treatment and after cessation (p = 0.29). The mean logMAR was 0.79 at baseline, 0.68 during treatment, and 0.88 at 12 months after cessation. These differences were not statistically significant.

CONCLUSIONS

A satisfactory clinical course with well-controlled ocular inflammation was found after discontinuation of infliximab therapy in Behçet's uveitis patients. These results suggest that a safe, pre-planned discontinuation of infliximab therapy can be performed in patients with Behçet's uveitis.

摘要

目的

研究停用以昔单抗治疗后贝赫切特葡萄膜炎患者的临床病程。

方法

本回顾性图表研究调查了 2000 年至 2012 年间接受以昔单抗治疗的贝赫切特病患者。回顾了停用以昔单抗治疗的患者的病历,特别关注在开始前、治疗期间和停用以昔单抗治疗后的葡萄膜炎发作频率。评估了每个治疗期的平均视力。

结果

在我们的葡萄膜炎诊所接受以昔单抗治疗的 43 名患者中,有 10 名因不良反应或无效而停用。分析了 7 名在开始和停止以昔单抗治疗后随访超过 12 个月的患者的数据。在开始以昔单抗治疗前,急性葡萄膜炎发作的频率为每 12 个月 7.43 次,治疗期间为 2.86 次,停止后为 0.57 次。与治疗期间相比,开始以昔单抗治疗前葡萄膜炎发作的频率更高(p<0.05),与停止治疗后相比也更高(p<0.05)。治疗期间与停止治疗后之间无统计学意义(p=0.29)。基线时平均 logMAR 为 0.79,治疗期间为 0.68,停止后 12 个月为 0.88。这些差异无统计学意义。

结论

在停用以昔单抗治疗后,贝赫切特葡萄膜炎患者的临床病程令人满意,眼部炎症得到良好控制。这些结果表明,在贝赫切特葡萄膜炎患者中,可以安全、有计划地停止以昔单抗治疗。

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