Infliximab in Refractory Uveitis Due to Behçet’s Disease: Long Term Follow-up and Therapy Optimization. Multicenter Study of 103 Caucasian Patients

José Luis Martín-Varillas¹, Belén Atienza-Mateo², Vanesa Calvo-Río³, Emma Beltran-Catalan⁴, Alfredo Adan⁵, Marisa Hernandez Garfella⁶, Elia Valls-Pascual⁷, Agustín Sellas-Fernández⁸, N Ortego⁹, Alejandro Fonollosa¹⁰, Olga Maiz Alonso¹¹, Ignacio Torre¹², Cruz Fernández-Espartero¹³, Vega Jovani¹⁴, Diana Peiteado¹⁵, David Díaz Valle¹⁶, Susana Romero-Yuste¹⁷, Elena Aurrecoechea¹, Miriam García-Arias¹⁸, Miguel Ángel Caracuel¹⁹, Santos Insúa²⁰, Senén González-Suárez²¹, Amalia Sánchez Andrade²², Luis Francisco Linares²³, Alfredo J García González²⁴, Raquel Almodovar²⁵, Carmen Carrasco Cubero²⁶, María Alcalde Villar²⁷, C Fernandez-Carballido²⁸, Fred A Pages²⁹, Eva Peña Sainz-Pardo²⁴, Rosalia Demetrio-Pablo³, Santos Castañeda³⁰, Miguel Ángel González-Gay³¹, José Luis Hernández³ and Ricardo Blanco³, ¹Hospital Sierrallana, Torrelavega, Spain, ²Research group on genetic epidemiology and atherosclerosis in systemic diseases and in metabolic bone diseases of the musculoskeletal system, IDIVAL; and Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain, ³Hospital Universitario Marques de Valdecilla, Santander, Spain, ⁴Del Mar University Hospital, Barcelona, ⁵Hospital Clinic, Barcelona, Catalonia, Spain, ⁶H. Valencia, Valencia, Spain, ⁷H. Doctor Peset, Valencia, Spain, ⁸H. Vall d'Hebron, Barcelona, Spain, ⁹H. San Cecilio, Granada, Spain, ¹⁰H. de Cruces, Bilbao, Spain, ¹¹Hospital Universitario Donostia, San Sebastian, Pais Vasco, Spain, ¹²Hospital Basurto, Bilbao, Spain, ¹³H. Mostoles, Madrid, Spain, ¹⁴H. Alicante, Alicante, Spain, ¹⁵Hospital La Paz - IdiPAZ, Madrid, Spain, ¹⁶H. Clínico San Carlos, Madrid, Spain, ¹⁷H Pontevedra, Coruna, Spain, ¹⁸H. La Princesa, Madrid, ¹⁹H.U. Reina Sofía, Córdoba, Spain, ²⁰H. Santiago de Compostela, Santiago de Compostela, Spain, ²¹H. Cabueñes, Gijón, Spain, ²²H. Lucus Augusti, Lugo, Spain, ²³Hospital de la Arrixaca, Murcia, ²⁴H. 12 de Octubre, Madrid, Spain, ²⁵Fundación Alcorcón University Hospital, Madrid, ²⁶H. Mérida, Mérida, Spain, ²⁷H. Severo Ochoa, Madrid, Spain, ²⁸H San Juan, Alicante, Spain, ²⁹H. Palencia, Palencia, Spain, ³⁰Princesa University Hospital, Universidad Autónoma, Madrid, Madrid, Spain, ³¹Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain

Meeting: ACR Convergence 2020

Keywords: Anti-TNF Drugs, Behçet's Syndrome, Eye Disorders, Vasculitis

Session Information

Date: Friday, November 6, 2020

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster I

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Biologic therapy has improved prognosis of Behçet Disease (BD) uveitis. Although infliximab (IFX) is approved in Japan, most data in Caucasian patients comes from small series and no data on IFX optimization has been published. In the present study we assessed: a) long-term efficacy and safety of IFX and b) IFX optimization when ocular remission was achieved

Methods: Multicenter study of IFX-treated patients with BD uveitis refractory to conventional immunosuppressants.103 patients were treated with IFX as 1st biologic as follows: 3-5 mg/kg i.v. at 0, 2, 6 and every 4-8 weeks. The main outcomes were anterior chamber cells, vitritis, retinal vasculitis, macular thickness, best corrected visual acuity, and the glucocorticoids sparing effect that were analysed at baseline, 1st week, 1st and 6th months and 1st and 2nd years. After remission, based on a shared decision between patient and clinician, IFX optimization was performed. Efficacy, safety, and IFX cost were evaluated

Results: In whole series (n=103), main outcomes showed a rapid and maintained improvement, reaching remission in 78 patients after a mean IFX duration of 31.5 months. Severe side-effects were observed in 9 patients.

In the optimization subanalysis, comparative study between optimized and non-optimized groups showed: a) no differences in clinical baseline characteristics; b) similar maintained improvement in most ocular outcomes; c) lower severe adverse events and d) lower IFX cost in optimized group (4826.52 vs. 9854.13 euros/patient/year) (Table)

Conclusion: IFX seems effective and relatively safe in Caucasian patients with refractory BD uveitis. IFX optimization is also effective, safe, and cost-effective

Main general features and follow-up of a subgroup of patients (n= 60) with Refractory Uveitis Due to BD who Achieved Remission after the standard dose of IFX therapy (5 mg/kg at 0, 2, 6 and then every 8 weeks). Differences between Optimized and Non-optimized patients

Disclosure: J. Martín-Varillas, None; B. Atienza-Mateo, None; V. Calvo-Río, None; E. Beltran-Catalan, None; A. Adan, None; M. Hernandez Garfella, None; E. Valls-Pascual, None; A. Sellas-Fernández, None; N. Ortego, None; A. Fonollosa, None; O. Maiz Alonso, Novartis, 1; I. Torre, None; C. Fernández-Espartero, None; V. Jovani, None; D. Peiteado, None; D. Díaz Valle, None; S. Romero-Yuste, None; E. Aurrecoechea, None; M. García-Arias, None; M. Caracuel, None; S. Insúa, None; S. González-Suárez, None; A. Sánchez Andrade, None; L. Linares, None; A. García González, None; R. Almodovar, None; C. Carrasco Cubero, None; M. Alcalde Villar, None; C. Fernandez-Carballido, None; F. Pages, None; E. Peña Sainz-Pardo, None; R. Demetrio-Pablo, None; S. Castañeda, Roche, 2; M. González-Gay, None; J. Hernández, None; R. Blanco, None.

To cite this abstract in AMA style:

Martín-Varillas J, Atienza-Mateo B, Calvo-Río V, Beltran-Catalan E, Adan A, Hernandez Garfella M, Valls-Pascual E, Sellas-Fernández A, Ortego N, Fonollosa A, Maiz Alonso O, Torre I, Fernández-Espartero C, Jovani V, Peiteado D, Díaz Valle D, Romero-Yuste S, Aurrecoechea E, García-Arias M, Caracuel M, Insúa S, González-Suárez S, Sánchez Andrade A, Linares L, García González A, Almodovar R, Carrasco Cubero C, Alcalde Villar M, Fernandez-Carballido C, Pages F, Peña Sainz-Pardo E, Demetrio-Pablo R, Castañeda S, González-Gay M, Hernández J, Blanco R. Infliximab in Refractory Uveitis Due to Behçet’s Disease: Long Term Follow-up and Therapy Optimization. Multicenter Study of 103 Caucasian Patients [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/infliximab-in-refractory-uveitis-due-to-behcets-disease-long-term-follow-up-and-therapy-optimization-multicenter-study-of-103-caucasian-patients/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/infliximab-in-refractory-uveitis-due-to-behcets-disease-long-term-follow-up-and-therapy-optimization-multicenter-study-of-103-caucasian-patients/