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Atienza-Mateo B, Martín-Varillas JL, Calvo-Río V, Demetrio-Pablo R, Beltrán E, Sánchez-Bursón J, Mesquida M, Adan A, Hernández MV, Hernández-Garfella M, Valls-Pascual E, Martínez-Costa L, Sellas-Fernández A, Cordero-Coma M, Díaz-Llopis M, Gallego R, García-Serrano JL, Ortego-Centeno N, Herreras JM, Fonollosa A, Garcia-Aparicio ÁM, Maíz-Alonso O, Blanco A, Torre-Salaberri I, Fernandez-Espartero C, Jovaní V, Peiteado D, Pato E, Cruz J, Férnandez-Cid C, Aurrecoechea E, García-Arias M, Castañeda S, Caracuel-Ruiz MA, Montilla-Morales CA, Atanes-Sandoval A, Francisco F, Insua S, González-Suárez S, Sanchez-Andrade A, Gamero F, Linares Ferrando LF, Romero-Bueno F, García-González AJ, González RA, Muro EM, Carrasco-Cubero C, Olive A, Prior Á, Vázquez J, Ruiz-Moreno O, Jiménez-Zorzo F, Manero J, Muñoz Fernandez S, Fernández-Carballido C, Rubio-Romero E, Pages FA, Toyos-Sáenz de Miera FJ, Martinez MG, Díaz-Valle D, López Longo FJ, Nolla JM, Álvarez ER, Martínez MR, González-López JJ, Rodríguez-Cundin P, Hernández JL, González-Gay MA, Blanco R. Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases. Arthritis Rheumatol 2019; 71:2081-2089. [PMID: 31237427 DOI: 10.1002/art.41026] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 06/19/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD). METHODS We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement. Patients received 3-5 mg/kg intravenous IFX at 0, 2, and 6 weeks and every 4-8 weeks thereafter, or 40 mg subcutaneous ADA every other week without a loading dose. Ocular parameters were compared between the 2 groups. RESULTS The study included 177 patients (316 affected eyes), of whom 103 received IFX and 74 received ADA. There were no significant baseline differences between treatment groups in main demographic features, previous therapy, or ocular sign severity. After 1 year of therapy, we observed an improvement in all ocular parameters in both groups. However, patients receiving ADA had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for IFX; P = 0.06), improvement in vitritis (93.33% versus 78.95% for IFX; P = 0.04), and best-corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for IFX; P = 0.001). A nonsignificant difference was seen for macular thickness (mean ± SD 250.62 ± 36.85 for ADA versus 264.89 ± 59.74 for IFX; P = 0.15), and improvement in retinal vasculitis was similar between the 2 groups (95% for ADA versus 97% for IFX; P = 0.28). The drug retention rate was higher in the ADA group (95.24% versus 84.95% for IFX; P = 0.042). CONCLUSION Although both IFX and ADA are efficacious in refractory BD-related uveitis, ADA appears to be associated with better outcomes than IFX after 1 year of follow-up.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Blanco
- Hospital Universitario de Donostia, San Sebastián, Spain
| | | | | | - Vega Jovaní
- Hospital General de Alicante, Alicante, Spain
| | | | | | - Juan Cruz
- Hospital de Pontevedra, Pontevedra, Spain
| | | | | | | | - Santos Castañeda
- Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain
| | | | | | | | | | - Santos Insua
- Hospital Universitario Santiago de Compostela, A Coruña, Spain
| | | | | | | | | | - F Romero-Bueno
- Jiménez Díaz Foundation University Hospital, Madrid, Spain
| | | | | | | | | | | | - Águeda Prior
- Germans Trias i Pujol Hospital, Barcelona, Spain
| | | | | | | | - Javier Manero
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | | | | | | | | | | | | | - Joan M Nolla
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | | | | | | | | | - Ricardo Blanco
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
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