Calvo-Río Vanesa, Blanco Ricardo, Beltrán Emma, Sánchez-Bursón Juán, Mesquida Marina, Adán Alfredo, Hernandez María Victoria, Hernandez Garfella Marisa, Valls Pascual Elia, Martínez-Costa Lucía, Sellas-Fernández Agustí, Cordero Coma Miguel, Díaz-Llopis Manuel, Gallego Roberto, Salom David, García Serrano José L, Ortego Norberto, Herreras José M, Fonollosa Alejandro, García-Aparicio Angel M, Maíz Olga, Blanco Ana, Torre Ignacio, Fernández-Espartero Cruz, Jovani Vega, Peiteado-Lopez Diana, Pato Esperanza, Cruz Juan, Fernández-Cid Carlos, Aurrecoechea Elena, García Miriam, Caracuel Miguel A, Montilla Carlos, Atanes Antonio, Hernandez Félix Francisco, Insua Santos, González-Suárez Senén, Sánchez-Andrade Amalia, Gamero Fernando, Linares Luis, Romero-Bueno Fredeswinda, García A Javier, Almodovar Raquel, Minguez Enrique, Carrasco Cubero Carmen, Olive Alejandro, Vázquez Julio, Ruiz Moreno Oscar, Jiménez-Zorzo Fernando, Manero Javier, Muñoz Fernández Santiago, Rueda-Gotor Javier, González-Gay Miguel A
Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Rheumatology, Hospital General Universitario de Valencia, Valencia, Rheumatology, Hospital de Valme, Sevilla, Ophthalmology and Rheumatology, Hospital Clinic, Barcelona, Ophthalmology, Hospital General Universitario de Valencia, Rheumatology and Ophthalmology, Hospital Peset Valencia, Valencia, Rheumatology Hospital Val d'Hebron, Barcelona, Ophthalmology Division, Hospital de León, Ophthalmology, Hospital Universitario La Fe, Valencia, Ophthalmology and Autoimmune Diseases, Hospital San Cecilio, Granada, Ophthalmology, Hospital Universitario, IOBA, Valladolid, Ophthalmology, Hospital de Cruces, Bilbao, Rheumatology, Hospital de Toledo, Rheumatology and Ophthalmology, Hospital Donosti San Sebastian, Rheumatology, Hospital Basurto, Bilbao, Rheumatology, Hospital Universitario de Móstoles, Rheumatology, Hospital General de Alicante, Rheumatology, Hospital Universitario La Paz Madrid, Rheumatology, Hospital Clínico San Carlos, Madrid, Rheumatology and Ophthalmology, Hospital de Pontevedra, Rheumatology, Hospital Sierrallana, Torrelavega, Rheumatology, Hospital La Princesa, Madrid, Rheumatology, Hospital de Córdoba, Rheumatology, Hospital Universitario de Salamanca, Rheumatology, HUCA La Coruña, Rheumatology, Hospital Doctor Negrín Canarias, Rheumatology, Hospital Universitario Santiago de Compostela, A Coruña, Rheumatology, Hospital Cabueñes, Gijón, Rheumatology, Hospital Lucus Augusti, Lugo, Rheumatology, Hospital San Pedro Alcantara, Caceres, Rheumatology, Hospital Arrixaca, Murcia, Rheumatology, Fundación Jiménez Díaz, Rheumatology, Hospital 12 de Octubre, Madrid, Rheumatology, Hospital Universitario Fundación Alcorcon, Ophthalmology, Hospital Clínico de Zaragoza, Rheumatology, Hospital de Merida, Rheumatology, Hospital Universitari Germans Trias i Pujol, Badalona, Rheumatology, Hospital de Ferrol, A Coruña, Ophthalmology, Rheumatology Hospital Miguel Servet, Zaragoza, and
Rheumatology (Oxford). 2014 Dec;53(12):2223-31. doi: 10.1093/rheumatology/keu266. Epub 2014 Jul 4.
The aim of this study was to assess the efficacy of anti-TNF-α therapy in refractory uveitis due to Behçet's disease (BD).
We performed a multicentre study of 124 patients with BD uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. Patients were treated for at least 12 months with infliximab (IFX) (3-5 mg/kg at 0, 2 and 6 weeks and then every 4-8 weeks) or adalimumab (ADA) (usually 40 mg every 2 weeks). The main outcome measures were degree of anterior and posterior chamber inflammation, visual acuity, macular thickness and immunosuppression load.
Sixty-eight men and 56 women (221 affected eyes) were studied. The mean age was 38.6 years (s.d. 10.4). HLA-B51 was positive in 66.1% of patients and uveitis was bilateral in 78.2%. IFX was the first biologic agent in 77 cases (62%) and ADA was first in 47 (38%). In most cases anti-TNF-α drugs were used in combination with conventional immunosuppressive drugs. At the onset of anti-TNF-α therapy, anterior chamber and vitreous inflammation was observed in 57% and 64.4% of patients, respectively. In both conditions the damage decreased significantly after 1 year. At baseline, 50 patients (80 eyes) had macular thickening [optical coherence tomography (OCT) >250 μm] and 35 (49 eyes) had cystoid macular oedema (OCT>300 μm) that improved from 420 μm (s.d. 119.5) at baseline to 271 μm (s.d. 45.6) at month 12 (P < 0.01). The best-corrected visual acuity and the suppression load also showed significant improvement. After 1 year of follow-up, 67.7% of patients were inactive. Biologic therapy was well tolerated in most cases.
Anti-TNF-α therapy is effective and relatively safe in refractory BD uveitis.
本研究旨在评估抗TNF-α疗法治疗白塞病（BD）所致难治性葡萄膜炎的疗效。
我们对124例经包括高剂量皮质类固醇和至少一种标准免疫抑制剂在内的传统治疗无效的BD葡萄膜炎患者进行了一项多中心研究。患者接受英夫利昔单抗（IFX）（0、2和6周时剂量为3 - 5 mg/kg，之后每4 - 8周一次）或阿达木单抗（ADA）（通常每2周40 mg）治疗至少12个月。主要观察指标为前房和后房炎症程度、视力、黄斑厚度和免疫抑制负荷。
共研究了68名男性和56名女性（221只患眼）。平均年龄为38.6岁（标准差10.4）。66.1%的患者HLA - B51呈阳性，78.2%的患者葡萄膜炎为双侧性。77例（62%）患者首次使用IFX作为生物制剂，4
