AUTHOR=Takeuchi Masaru , Usui Yoshihiko , Namba Kenichi , Keino Hiroshi , Takeuchi Masaki , Takase Hiroshi , Kamoi Koju , Hase Keitaro , Ito Takako , Nakai Kei , Maruyama Kazuichi , Kobayashi Eri , Mashimo Hisashi , Sato Tomohito , Ohguro Nobuyuki , Hori Junko , Okada Annabelle A. , Sonoda Koh-hei , Mizuki Nobuhisa , Goto Hiroshi 

TITLE=Ten-year follow-up of infliximab treatment for uveitis in Behçet disease patients: A multicenter retrospective study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1095423

DOI=10.3389/fmed.2023.1095423

ISSN=2296-858X

ABSTRACT=Purpose: To evaluate 10-year outcome of infliximab (IFX) treatment for uveitis in Behçet disease (BD) patients using a standardized follow-up protocol.
Design: Retrospective longitudinal cohort study.
Participants: 140 BD uveitis patients treated with IFX enrolled in our previous study.
Methods: Medical records were reviewed for demographic information, duration of IFX treatment, number of ocular attacks before IFX initiation, best corrected visual acuity (VA) at baseline and 1, 2, 3, 4, 5 and 10 years after IFX initiation, uveitis recurrence after IFX initiation and main anatomical site, concomitant therapies, and adverse events (AEs).
Main outcome measures: 10-year IFX continuation rate and change in LogMAR VA.
Results: Of 140 BD patients, 106 (75.7%) continued IFX treatment for 10 years. LogMAR VA improved gradually after initiation of IFX, and the improvement reached statistical significance from 2 years of treatment. Thereafter, significant improvement compared with baseline was maintained until 10 years, despite a slight deterioration of logMAR VA from 5 years. However, eyes with worse baseline decimal VA < 0.1 showed no significant improvement from baseline to 10 years. Uveitis recurred after IFX initiation in 50 patients (recurrence group) and did not recur in 56 (non-recurrence group). Ocular attacks/year before IFX initiation was significantly higher in the recurrence group (2.82 ± 3.81) than in the non-recurrence group (1.84 ± 1.78). In the recurrence group, uveitis recurred within 1 year in 58% and within 2 years in 74%. Seventeen patients (34%) had recurrent anterior uveitis, 17 (34%) had posterior uveitis, and 16 (32%) had panuveitis, with no significant difference in VA outcome. In addition, logMAR VA at 10 years did not differ between the recurrence and non-recurrence groups. AEs occurred among 43 patients (30.7%), and 24 (17.1%) resulted in IFX discontinuation before 10 years.
Conclusions: Among BD patients with uveitis who initiated IFX, approximately 75% continued treatment for 10 years, and their VA improved significantly and was maintained for 10 years. Uveitis recurred in one-half of the patients, but visual acuity did not differ significantly from the patients without recurrence.