Maalouf Georgina, Andrillon Anaïs, Leclercq Mathilde, Sève Pascal, Bielefeld Philip, Gueudry Julie, Sené Thomas, Titah Cherif, Moulinet Thomas, Rouvière Bénédicte, Sène Damien, Desbois Anne-Claire, Domont Fanny, Touhami Sara, Thibault Thomas, Chamieh Carolla El, Cacoub Patrice, Kodjikian Laurent, Biard Lucie, Bodaghi Bahram, Saadoun David
From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France.
Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France.
Am J Ophthalmol. 2022 Jun;238:173-180. doi: 10.1016/j.ajo.2022.02.002. Epub 2022 Feb 13.
To compare the relapse rate of sight-threatening noninfectious uveitis (NIU) in patients treated with infliximab (IFX) or adalimumab (ADA).
Observational retrospective multicenter study.
A total of 330 patients (median age, 36 years; interquartile range, 27-54), 45.2% men) with sight-threatening NIU (ie, retinal vasculitis and/or macular edema) treated with anti-tumor necrosis factor [TNF]-α agents (IFX intravenously at 5 mg/kg at weeks 0, 2, 6, and every 4 to 6 weeks or ADA subcutaneously at 80 mg, then 40 mg every 2 weeks). Data were obtained retrospectively from patients' medical records. Main outcome measures were relapse rate, complete response of NIU, corticosteroid sparing effect, and safety.
Main etiologies of uveitis included Behçet disease (27%), idiopathic juvenile arthritis (5.8%), and sarcoidosis (5.5%). The estimated relapse rate at 6 months after introduction of biological agents was 13% (95% CI = 0.009-0.16). IFX was associated with less relapse risk than ADA (hazard ratio [HR] = 0.52, 95% CI = 0.36- 0.77, P = .001). ADA and IFX were comparable in terms of complete response rate of NIU as well as corticosteroid-sparing effect. Behçet disease was associated with higher odds of complete response (HR = 2.04, 95% CI = 1.16 -3.60, P = .01] and lower relapse rate (HR = 0.53, 95% CI = 0.33-0.85, P = .009) than other causes of NIU with anti-TNF-α agents.
In sight-threatening NIU, IFX seems to be associated with a lower relapse rate than ADA.
比较接受英夫利昔单抗（IFX）或阿达木单抗（ADA）治疗的威胁视力的非感染性葡萄膜炎（NIU）患者的复发率。
观察性回顾性多中心研究。
共有330例患者（中位年龄36岁；四分位间距27 - 54岁），45.2%为男性，患有威胁视力的NIU（即视网膜血管炎和/或黄斑水肿），接受抗肿瘤坏死因子（TNF）-α药物治疗（IFX静脉注射，第0、2、6周剂量为5 mg/kg，之后每4至6周一次；或ADA皮下注射，初始剂量80 mg，之后每2周40 mg）。数据通过回顾患者病历获得。主要观察指标为复发率、NIU的完全缓解率、糖皮质激素节省效应和安全性。
葡萄膜炎的主要病因包括白塞病（27%）、特发性幼年关节炎（5.8%）和结节病（5.5%）。引入生物制剂后6个月的估计复发率为13%（95%可信区间[CI]=0.009 - 0.16）。与ADA相比，IFX的复发风险更低（风险比[HR]=0.52，95% CI =
0.36 - 0.77，P = 0.001）。ADA和IFX在NIU的完全缓解率以及糖皮质激素节省效应方面相当。与其他使用抗TNF-α药物治疗的NIU病因相比，白塞病的完全缓解几率更高（HR = 2.04，95% CI = 1.16 - 3.60，P = 0.01）且复发率更低（HR = 0.53，95% CI = 0.33 - 0.85，P = 0.009）。
在威胁视力的NIU中，IFX似乎比ADA的复发率更低。
