ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2853

Comparative Study of Infliximab Versus Adalimumab in Patients with Refractory Uveitis Due to Behçet´s Disease. Multicenter Study of 125 Cases

Leyre Riancho-Zarrabeitia1, Vanesa Calvo-Río1, Ricardo Blanco1, Paz Rodríguez-Cundín2, Emma Beltrán3, Juan Sánchez Bursón Sr.4, Marina Mesquida5, Alfredo Adan5, M. Victoria Hernández6, Marisa Hernandez Grafella7, Elia Valls Pascual8, Lucía Martinez-Costa9, Agusti Sellas-Fernandez10, Miguel Cordero-Coma11, Manuel Díaz-Llopis12, Roberto Gallego12, Jose Luis García Serrano13, Norberto Ortego-Centeno14, Jose M Herreras15, Alejandro Fonollosa16, Angel M. Garcia-Aparicio17, Olga Maiz Alonso18, Ana Blanco19, Ignacio Torre Salaberri20, Cruz Fernández- Espartero21, Vega Jovani22, Diana Peiteado23, Esperanza Pato24, Juan Cruz25, Carlos Férnandez Cid26, Elena Aurrecoechea27, Miriam García-Arias28, Miguel Angel Caracuel-Ruiz29, Carlos Alberto Montilla Morales30, Antonio Atanes-Sandoval31, Félix Francisco32, Santos Insua33, Senen González-Suárez34, Maria Amalia Sanchez Andrade35, Fernando Gamero36, Luis Francisco Linares Ferrando37, Fredeswinda Romero38, A. Javier García-González39, Raquel Almodóvar González40, Enrique Minguez41, Carmen Carrasco Cubero42, Alejandro Olive43, Julio Vázquez44, Oscar Ruiz Moreno45, Fernando Jiménez-Zorzo45, Javier Manero45, Santiago MuÑoz Fernandez46, Javier Rueda-Gotor1, Trinitario Pina1, Montserrat Santos-Gómez1 and Miguel A. González-Gay1, 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Spain, Santander, Spain, 2Preventive Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Spain, Santander, Spain, 3Rheumatology, Hospital General Universitario de Valencia. Spain, Valencia, Spain, 4Rheumatology. Hospital de Valme., Sevilla, Spain, 5Ophthalmology, Hospital Clinic. Barcelona. Spain, Barcelona, Spain, 6Arthritis Unit, Department of Rheumatology, Hospital Clinic, Barcelona, Barcelona, Spain, 7Ophthalmology. Hospital General universitario de Valencia, Valencia, Spain, 8Rheumatology. Hospital Peset, Valencia, Spain, 9Ophthalmology. Hospital Peset, Valencia, Spain, 10H. Vall d'Hebron, Barcelona, Spain, 11Ophthalmology, Hospital de León. Spain, León, Spain, 12Ophthalmology, Hospital Universitario La Fe. Valencia. Spain, Valencia, Spain, 13Ophthalmology. Hospital San Cecilio, Granada, Spain, 14Systemic Autoimmune Diseases Unit, Hospital Clínico San Cecilio, Granada, Spain, 15Ophthalmology. Hospital Universitario, IOBA, Valladolid, Spain, 16Ophthalmology, Hospital de Cruces. Bilbao. Spain, Bilbao, Spain, 17Rheumatology, Virgen de la Salud Hospital, Toledo, Spain, 18Rheumatology, Hospital Universitario de Donostia. San Sebastián. Spain, San Sebastián, Spain, 19Ophthalmology. Hospital Donosti, San Sebastián, Spain, 20Rheumatology, Hospital Universitario de Basurto. Bilbao. Spain, Bilbao, Spain, 21Rheumatology, Hospital Universitario de Móstoles. Madrid. Spain, Madrid, Spain, 22Rheumatology. Hospital General de Alicante, Alicante, Spain, 23Rheumatology, Hospital La Paz - IdiPaz, Madrid, Spain, 24Rheumatology. Hospital Clínico San Carlos, Madrid, Spain, 25Rheumatology. Hospital de Pontevedra, Pontevedra, Spain, 26Ophthalmology. Hospital de Pontevedra, Pontevedra, Spain, 27Hospital Sierrallana. Torrelavega, Torrelavega, Spain, 28Rheumatology, Hospital Universitario de La Princesa. IIS La Princesa, Madrid, Spain, 29Plaza Cruz Roja, 1, H. Reina Sofia, Cordoba, Spain, 30Hospital Clínico Universitario de Salamanca, Salamanca, Spain, 31Rheumatology Division. C. Hospitalario Universitario A Coruña, A Coruña, Spain, 32Rheumatology, Hospital Doctor Negrín. Las Palmas de Gran Canaria. Spain, Las Palmas de Gran Canaria, Spain, 33Rheumatology. Hospital Universitario Santiago de Compostela, A Coruña, Spain, 34Rheumatology. Hospital Cabueñes, Gijón, Spain, 35Hosp. Lucus Augusti, Lugo, Spain, 36Rheumatology. Hospital San Pedro Alcantara, Cáceres, Spain, 37Rheumatology, Hospital Virgen de la Arrixaca. Murcia. Spain, Murcia, Spain, 38Rheumatology, Jiménez Díaz Foundation University Hospital, Madrid, Spain, 39Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre (I+12), Madrid, Spain, 40Rheumatology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain, 41Ophthalmology. Hospital Clínico de Zaragoza, Zaragoza, Spain, 42Rheumatology, Hospital de Merida, Mérida, Spain, 43Rheumatology Service, Germans Trias Pujol Hospital, Barcelona, Spain, 44Rheumatology. Hospital de Ferrol, A Coruña, Spain, 45Ophthalmology and Rheumatology. Hospital Miguel Servet Zaragoza, Spain, Zaragoza, Spain, 46Sección de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Vasculitis III

Session Type: Abstract Submissions (ACR)

Background/Purpose: To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as first biologic drug in refractory uveitis due to Behçet’s disease (BD) for 1-year period.

Methods: Multicenter study of patients with BDxs uveitis refractory to conventional treatment including high-dose corticosteroids and at least one standard immunosuppressive agent. IFX (3-5 mg/kg at 0, 2, and 6 weeks and then every 4-8 weeks) was used in 75 cases and ADA (usually 40 mg every 2 weeks) in 50 cases. The main comparative outcome measures were improvement of visual acuity (VA) (at least 20%), complete inactivity of anterior chamber inflammation, vitritis, and retinal vasculitis as well as macular thickness <250 microns. A bivariate and logistic regression analysis was performed for every previous outcome between ADA vs IFX (SPSS20.0 package).

Results: We studied 125 patients (223 affected eyes). No statistically significant differences at baseline were observed between IFX vs ADA groups in sex (♂/♀; 41/34 vs 29/21; p=0.71), mean age (39.2±9.39 vs 36.14±12.7 years; p= 0.12), HLA-B51 positive (75% vs 75%), uveitis duration before anti TNFα onset (median [IQR]; 36 [12-71] vs 24 months [12-60]; p=0.4), VA (0.47±0.26 vs 0.52±0.27; p=0.29), anterior chamber cells (median [IQR]; 0.5 [0-2] vs 1.5 [0-2]; p=0.2), retinal vasculitis (73.2% vs 75%; p=0.95); macular thickness (285.90±90.15 vs 312.02±106.57; p=0.25), combined treatment (82.7% vs 77.6%; p= 0.481), basal degree of immunosuppression (mean±SD; 11.35± 5.67 vs 9.65±4.68; p= 0.09). After 1 year of therapy, ADA yielded a non-statistically significant increased frequency of improvement of VA, complete inactivity of anterior chamber inflammation, and macular thickness < 250 microns when compared with IFX. In contrast, a slight increased frequency of inactive vitritis and improvement of retinal vasculitis was observed in IFX-treated patients but the difference was not statistically significant (Table).

Conclusion: After 1 year of therapy ADA and IFX do not show differences in the visual outcome of patients with refractory uveitis due to BD.

Table: Treatment results at 1 year of therapy: Differences between ADA and IFX.

ADA / IFX (%)

Crude Odds ratio (95% confidence interval)

p

Adjusted Odds ratio*

p

Visual acuity improvement (>20%)

66.7% / 48.2%

2.148 (0.879-5.250)

0.094

1.84

0.214

Inactive anterior chamber inflammation

67.6% / 61.2%

1.324 (0.528-3.323)

0.550

1.669

0.346

Inactive Vitritis

60.5% / 66.7%

0.767 (0.330-1.782)

0.537

0.867

0.765

Improvement of retinal vasculitis

85.2% / 93%

0.431 (0.089-2.099)

0.298

0.340

0.217

Macular thickness

< 250 microns

36.8% / 21.7%

2,100 (0.539-8.185)

0.285

1.447

0.620

* adjusted for age, sex, and disease duration.

Disclosure:

L. Riancho-Zarrabeitia,
None;

V. Calvo-Río,
None;

R. Blanco,
None;

P. Rodríguez-Cundín,
None;

E. Beltrán,
None;

J. Sánchez Bursón Sr.,
None;

M. Mesquida,
None;

A. Adan,
None;

M. V. Hernández,
None;

M. Hernandez Grafella,
None;

E. Valls Pascual,
None;

L. Martinez-Costa,
None;

A. Sellas-Fernandez,
None;

M. Cordero-Coma,
None;

M. Díaz-Llopis,
None;

R. Gallego,
None;

J. L. García Serrano,
None;

N. Ortego-Centeno,
None;

J. M. Herreras,
None;

A. Fonollosa,
None;

A. M. Garcia-Aparicio,
None;

O. Maiz Alonso,
None;

A. Blanco,
None;

I. Torre Salaberri,
None;

C. Fernández- Espartero,
None;

V. Jovani,
None;

D. Peiteado,
None;

E. Pato,
None;

J. Cruz,
None;

C. Férnandez Cid,
None;

E. Aurrecoechea,
None;

M. García-Arias,
None;

M. A. Caracuel-Ruiz,
None;

C. A. Montilla Morales,
None;

A. Atanes-Sandoval,
None;

F. Francisco,
None;

S. Insua,
None;

S. González-Suárez,
None;

M. A. Sanchez Andrade,
None;

F. Gamero,
None;

L. F. Linares Ferrando,
None;

F. Romero,
None;

A. J. García-González,
None;

R. Almodóvar González,
None;

E. Minguez,
None;

C. Carrasco Cubero,
None;

A. Olive,
None;

J. Vázquez,
None;

O. Ruiz Moreno,
None;

F. Jiménez-Zorzo,
None;

J. Manero,
None;

S. MuÑoz Fernandez,
None;

J. Rueda-Gotor,
None;

T. Pina,
None;

M. Santos-Gómez,
None;

M. A. González-Gay,
None.

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