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术前及术后英夫利昔单抗在控制接受玻璃体切除术的白塞病后葡萄膜炎患者病情中的有效性:一项初步研究

The Effectiveness of Pre- and Postoperative Infliximab in Controlling Behçet's Disease Posterior Uveitis in Patients Undergoing Vitrectomy: A Preliminary Study.

作者信息

Khalil Hossam El Din Mohamed, Gendy Heba A El, Raafat Hala Ahmed, Haroun Hazem Effat, Gheita Tamer Atef, Bakir Hossam Mahmoud

机构信息

Department of Ophthalmology, Faculty of Medicine, Beni Sweif University, Beni Sweif, Egypt.

Department of Ophthalmology, Faculty of Medicine, Cairo University, Giza, Egypt.

出版信息

J Ophthalmol. 2017;2017:8168369. doi: 10.1155/2017/8168369. Epub 2017 Apr 4.

Abstract

To evaluate the short-term effectiveness of infliximab in controlling ocular manifestations in Behçet's Disease (BD) patients candidate for pars plana vitrectomy, if given in a regimen before and after the planned procedure. 30 eyes of 27 adult male BD patients with a mean age of 35.56 yrs presented with refractory posterior uveitis not responding to immunosuppressive drugs and candidate for vitrectomy were included. Infliximab was given in a dose of 5 mg/kg intravenous infusion once every two weeks for 3 treatment sessions before the intended vitrectomy followed by 3 treatment sessions at two-week intervals, after vitrectomy. Improvement of ocular manifestations was noted in all eyes, with complete resolution in 26 eyes (87%). Visual acuity improved from 0.23 ± 0.11 to 0.38 ± 0.17 ( ≤ 0.2), ESR decreased from 65.92 mm/hr ± 17.32 SD to 24.93 mm/hr ± 5.28 SD at the last treatment cycle ( ≤ 0.1). The mean daily dose of systemic corticosteroids was tapered from 44.54 mg/d ± 2.89 to 8.48 mg/d ± 6.38 ( ≤ 0.2), and no relapses were noted during the follow-up period. Infliximab may be safe and effective in controlling posterior uveitis and inducing remissions if given in a regimen before and after vitrecomy in BD patients.

摘要

为评估英夫利昔单抗在控制白塞病(BD)患者眼部表现方面的短期疗效,这些患者计划进行玻璃体切割术,观察在计划手术前后给予该药物方案的效果。纳入了27例成年男性BD患者的30只眼,平均年龄35.56岁,这些患者患有难治性后葡萄膜炎,对免疫抑制药物无反应且计划进行玻璃体切割术。在预期的玻璃体切割术前,英夫利昔单抗以5mg/kg的剂量静脉输注,每两周一次,共进行3个疗程,玻璃体切割术后,以两周的间隔再进行3个疗程。所有眼睛的眼部表现均有改善,26只眼(87%)完全缓解。视力从0.23±0.11提高到0.38±0.17(≤0.2),在最后一个治疗周期时,红细胞沉降率(ESR)从65.92mm/hr±17.32标准差降至24.93mm/hr±5.28标准差(≤0.1)。全身糖皮质激素的平均每日剂量从44.54mg/d±2.89减至8.48mg/d±6.38(≤0.2),随访期间未观察到复发。对于BD患者,如果在玻璃体切割术前后给予英夫利昔单抗方案,其在控制后葡萄膜炎和诱导缓解方面可能是安全有效的。

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EULAR recommendations for the management of Behçet disease.欧洲抗风湿病联盟(EULAR)关于白塞病管理的建议。
Ann Rheum Dis. 2008 Dec;67(12):1656-62. doi: 10.1136/ard.2007.080432. Epub 2008 Jan 31.

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