title: Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in Behçet's disease: an open-label trial.
abstract: OBJECTIVE
  To investigate the effect of infliximab on the frequency of uveitis attacks and the visual prognosis in male patients with Behçet's disease in whom uveitis was resistant to combination therapy with corticosteroids, azathioprine, and cyclosporine.
  
  
  METHODS
  The study group comprised patients who were receiving combination therapy but experienced at least 2 attacks of posterior uveitis/panuveitis or retinal vasculitis during the 6-month period prior to enrollment. Infliximab infusions (5 mg/kg) were administered at weeks 0, 2, 6, and 14. Weeks 0-22 were defined as the infusion period, and weeks 23-54 were defined as the observation period. Patients continued to receive azathioprine and corticosteroids, but cyclosporine was discontinued after the screening visit. The primary outcome measures were the absence of uveitis attacks during the infusion period (remission), and the absence of uveitis attacks throughout the study period (sustained remission).
  
  
  RESULTS
  Thirteen patients were enrolled in the study. Thirty-two uveitis attacks involving the posterior segment occurred during the previous-treatment period. During the infusion period, 4 patients (30.8%) remained attack-free, and 9 patients had a total of 13 uveitis attacks. Ten of these attacks (76.9%) occurred at either week 14 or week 22. One of 13 patients fulfilled the definition of sustained remission, and the remaining 12 patients had a total of 36 uveitis attacks during the observation period. The mean number of uveitis attacks and daily corticosteroid doses were significantly lower during the infusion period than during the previous-treatment period or the observation period. Although potential visual acuity was regained following infliximab infusion, this beneficial effect was not preserved until week 54. None of the patients experienced a serious adverse event.
  
  
  CONCLUSIONS
  The results of this trial suggest that infliximab is effective in suppressing the occurrence of uveitis attacks, has a corticosteroid-sparing effect, and has favorable implications for the visual prognosis of patients with resistant Behçet's uveitis.
authors.affiliation: Istanbul University, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Tugal-Tutkun
authors.forename: Abdulbaki
authors.initials: A
authors.lastname: Mudun
authors.forename: Meri
authors.initials: M
authors.lastname: Urgancioglu
authors.forename: Sevil
authors.initials: S
authors.lastname: Kamali
authors.forename: Esen
authors.initials: E
authors.lastname: Kasapoglu
authors.forename: Murat
authors.initials: M
authors.lastname: Inanc
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gül
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000150:complications*; D016572:Cyclosporine / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine; D000069285:Infliximab; D001379:Azathioprine