title: Infliximab Versus Adalimumab in the Treatment of Refractory Inflammatory Uveitis: A Multicenter Study From the French Uveitis Network.
abstract: To analyze the factors associated with response to anti-tumor necrosis factor (anti-TNF) treatment and compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in patients with refractory noninfectious uveitis.
  
  
  
  This was a multicenter observational study of 160 patients (39% men and 61% women; median age 31 years [interquartile range 21-42]) with uveitis that had been refractory to other therapies, who were treated with anti-TNF (IFX 5 mg/kg at weeks 0, 2, 6, and then every 5-6 weeks [n = 98] or ADA 40 mg every 2 weeks [n = 62]). Factors associated with complete response were assessed by multivariate analysis. Efficacy and safety of IFX versus ADA were compared using a propensity score approach with baseline characteristics taken into account. Subdistribution hazard ratios (SHRs) and 95% confidence intervals (95% CIs) were calculated.
  
  
  
  The main etiologies of uveitis included Behçet's disease (BD) (36%), juvenile idiopathic arthritis (22%), spondyloarthropathy (10%), and sarcoidosis (6%). The overall response rate at 6 and 12 months was 87% (26% with complete response) and 93% (28% with complete response), respectively. The median time to complete response was 2 months. In multivariate analysis, BD and occurrence of >5 uveitis flares before anti-TNF initiation were associated with complete response to anti-TNF (SHR 2.52 [95% CI 1.35-4.71], P = 0.004 and SHR 1.97 [95% CI 1.02-3.84], P = 0.045, respectively). Side effects were reported in 28% of patients, including serious adverse events in 13%. IFX and ADA did not differ significantly in terms of occurrence of complete response (SHR 0.65 [95% CI 0.25-1.71], P = 0.39), serious side effects (SHR 0.22 [95% CI 0.04-1.25], P = 0.089), or event-free survival (SHR 0.55 [95% CI 0.28-1.08], P = 0.083).
  
  
  
  Anti-TNF treatment is highly effective in refractory inflammatory uveitis. BD is associated with increased odds of response. IFX and ADA appear to be equivalent in terms of efficacy.
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Vallet
authors.affiliation: Hôpital Croix Rousse, Lyon, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Seve
authors.affiliation: Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Biard
authors.affiliation: Hôpital Jean Verdier, Bondy, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Baptiste Fraison
authors.affiliation: Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France.
authors.forename: Philip
authors.initials: P
authors.lastname: Bielefeld
authors.affiliation: Hôpital Edouard Herriot, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Perard
authors.affiliation: CHU de Caen, Caen, France.
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
authors.affiliation: Hôpital Avicenne, Bobigny, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Abad
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Rigolet
authors.affiliation: CHU de Grenoble-Hôpital Michallon, Grenoble, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Deroux
authors.affiliation: Hôpital Lariboisière, AP-HP, Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Sene
authors.affiliation: CHU de Rennes, Rennes, France.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Perlat
authors.affiliation: CHU de Rouen, Rouen, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marie
authors.affiliation: Hôpital Croix Rousse, Lyon, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Feurer
authors.affiliation: Eric Hachulla, MD, PhD: Centre Hospitalier Régional Universitaire de Lille, Lille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Hôpital Saint Antoine, AP-HP, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
authors.affiliation: A. Rothschild Foundation, Paris, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Clavel
authors.affiliation: CHU de Montpellier, Montpellier, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Riviere
authors.affiliation: Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France.
authors.forename: Pierre-Alban
authors.initials: PA
authors.lastname: Bouche
authors.affiliation: CHU de Rouen, Rouen, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Gueudry
authors.affiliation: CHU de Toulouse-Hôpital Purpan, INSERM UMR 1027, Toulouse, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Pugnet
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: Phuc
authors.initials: P
authors.lastname: Le Hoang
authors.affiliation: Hôpital Saint Louis and Le Centre de Recherche INSERM, Paris Sorbonne Cité, UMR 1153, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche Rigon
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
authors.affiliation: Hôpital Pitié-Salpêtrière, AP-HP, Centre National de Référence Maladies Systémiques et Autoimmunes Rares, and Université Paris VI, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Saadoun
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D012074:Remission Induction; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab