title: Evaluation of the long-term efficacy and safety of infliximab treatment for uveitis in Behçet's disease: a multicenter study.
abstract: OBJECTIVE
  To evaluate the long-term efficacy and safety of infliximab for the treatment of uveitis in Behçet's disease (BD).
  
  
  METHODS
  Retrospective multicenter study using a questionnaire.
  
  
  METHODS
  A total of 164 consecutive patients with BD treated with infliximab for more than 1 year were studied. The mean age at initiation of infliximab treatment was 42.6±11.7 years, and the mean treatment duration was 32.9±14.4 months.
  
  
  METHODS
  Data before and at the last visit during infliximab treatment were analyzed in 4 groups divided by duration of treatment: group A (n = 43, 12-<24 months), group B (n = 62, 24-<36 months), group C (n = 42, 36-<48 months), and group D (n = 17, ≥48 months).
  
  
  METHODS
  Best-corrected visual acuity (BCVA), relapse of ocular inflammation, numbers of ocular inflammatory attacks per year, and adverse effects of infliximab therapy.
  
  
  RESULTS
  The frequency of ocular attacks decreased in all groups (from 5.3±3.0 to 1.0±0.3 in group A, 4.8±4.6 to 1.4±0.3 in group B, 4.1±2.9 to 0.9±0.3 in group C, and 9.5±5.8 to 1.6±0.5 in group D; all P < 0.05). The BCVA was improved in approximately 55% of the eyes after treatment. Mean BCVA converted to logarithm of the minimum angle of resolution was improved after treatment with infliximab in groups A to C (from 0.79±1.04 to 0.59±0.94 in group A, 0.59±1.07 to 0.41±1.04 in group B, and 1.15±1.77 to 0.92±1.73 in group C; all P < 0.05) but not in group D. Uveitis relapsed in 59.1% of all patients after infliximab treatment, and no difference in duration until relapse was observed between individual groups. Approximately 80% of relapses occurred within 1 year after the initiation of infliximab treatment in all groups, 90% of which were controlled by increasing doses of topical corticosteroids and shortening the interval of infliximab infusion. Adverse effects were observed in 65 cases or 35% of all subjects. Infliximab treatment was continued in 85% of the patients, but 15% of the patients discontinued infliximab treatment because of adverse effects or insufficient efficacy.
  
  
  CONCLUSIONS
  Infliximab reduced the frequency of ocular attacks and improved visual acuity in patients with BD-related uveitis and was generally well tolerated with few serious adverse events.
authors.affiliation: Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan. Electronic address: masatake@ndmc.ac.jp.
authors.forename: Masaru
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kezuka
authors.affiliation: Laboratory for Retinal Regeneration, Center for Developmental Biology, RIKEN, Kobe, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Sugita
authors.affiliation: Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Keino
authors.affiliation: Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Namba
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Kaburaki
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nakai
authors.affiliation: Department of Ophthalmology, Graduate School of Medicine, Kyushu University, Fukuoka City, Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Hijioka
authors.affiliation: Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Shibuya
authors.affiliation: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Komae
authors.affiliation: Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Hori
authors.affiliation: Department of Ophthalmology, Osaka Koseinennkinn Hospital, Osaka, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohguro
authors.affiliation: Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Koh-hei
authors.initials: KH
authors.lastname: Sonoda
authors.affiliation: Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Mizuki
authors.affiliation: Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Annabelle A
authors.initials: AA
authors.lastname: Okada
authors.affiliation: Department of Ophthalmology, Graduate School of Medicine, Kyushu University, Fukuoka City, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishibashi
authors.affiliation: Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Mochizuki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D000069285:Infliximab