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Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases
Author(s) -
AtienzaMateo Belén,
MartínVarillas José Luis,
CalvoRío Vanesa,
DemetrioPablo Rosalía,
Beltrán Emma,
SánchezBursón Juan,
Mesquida Marina,
Adan Alfredo,
Hernández María Victoria,
HernándezGarfella Marisa,
VallsPascual Elia,
MartínezCosta Lucía,
SellasFernández Agustí,
CorderoComa Miguel,
DíazLlopis Manuel,
Gallego Roberto,
GarcíaSerrano José L.,
OrtegoCenteno Norberto,
Herreras José M.,
Fonollosa Alejandro,
GarciaAparicio Ángel M.,
MaízAlonso Olga,
Blanco Ana,
TorreSalaberri Ignacio,
FernandezEspartero Cruz,
Jovaní Vega,
Peiteado Diana,
Pato Esperanza,
Cruz Juan,
FérnandezCid Carlos,
Aurrecoechea Elena,
GarcíaArias Miriam,
Castañeda Santos,
CaracuelRuiz Miguel A.,
MontillaMorales Carlos A.,
AtanesSandoval Antonio,
Francisco Félix,
Insua Santos,
GonzálezSuárez Senen,
SanchezAndrade Amalia,
Gamero Fernando,
Linares Ferrando Luis F.,
RomeroBueno F.,
GarcíaGonzález A. Javier,
González Raquel Almodóvar,
Muro Enrique Minguez,
CarrascoCubero Carmen,
Olive Alejandro,
Prior Águeda,
Vázquez Julio,
RuizMoreno Oscar,
JiménezZorzo Fernando,
Manero Javier,
Muñoz Fernandez Santiago,
FernándezCarballido Cristina,
RubioRomero Esteban,
Pages Fred Antón,
ToyosSáenz de Miera Francisco J.,
Martinez Myriam Gandia,
DíazValle David,
López Longo Francisco J.,
Nolla Joan M.,
Álvarez Enrique Raya,
Martínez Marcelino Revenga,
GonzálezLópez Julio José,
RodríguezCundin Paz,
Hernández José L.,
GonzálezGay Miguel A.,
Blanco Ricardo
Publication year - 2019
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.41026
Subject(s) - medicine , infliximab , adalimumab , refractory (planetary science) , uveitis , behcet's disease , surgery , disease , ophthalmology , physics , astrobiology
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.