TY - JOUR
TI - A single infliximab infusion vs corticosteroids for acute panuveitis
attacks in Behcet's disease: a comparative 4-week study
AU - Markomichelakis, Nikos
AU - Delicha, Evi
AU - Masselos, Stylianos and
AU - Fragiadaki, Kalliopi
AU - Kaklamanis, Phaedon
AU - Sfikakis, Petros P.
JO - Rheumatology (Bulgaria)
PY - 2011
VL - 50
TODO - 3
SP - 593-597
PB - Oxford University Press
SN - null
TODO - 10.1093/rheumatology/keq366
TODO - Behcet’s disease; Infliximab; Methylprednisolone; Triamcinolone;
Panuveitis; Retinitis; Visual acuity; Treatment
TODO - Methods. A prospective, observational study of patients with panuveitis,
who received either an infliximab infusion (5 mg/kg, 19 eyes) or
high-dose methylprednisolone intravenously (1 g/day for 3 days, 8 eyes),
or intra-vitreal triamcinolone acetonide (4 mg, 8 eyes) at attack’s
onset. Baseline maintenance therapy remained unchanged during the
following 30 days. Visual acuity, anterior chamber cells, vitreous cells
and inflammation of the posterior eye segment were assessed at baseline
and at Days 1, 7, 14 and 29 (+/- 1) post-treatment.
Results. While no significant differences were noted between i.v. and
intra-vitreal CSs, infliximab was faster than CSs in decreasing total
ocular inflammation scores and fundus inflammation scores (P = 0.01 and
P < 0.0001 for treatment x time(2) interaction, respectively, using
generalized estimating equation analysis). Independently of time,
infliximab was superior to CSs in clearing retinal vasculitis (P <
0.003), as well as in resolution of retinitis (P = 0.008) and cystoid
macular oedema (P < 0.007). Moreover, a faster regression of cystoid
macular oedema was observed with infliximab compared with CSs (P <
0.03). The beneficial effects of the three treatment modalities on
visual acuity were comparable from baseline to the end of follow-up. No
side effects were noted with infliximab or methylprednisolone, whereas
intra-vitreal triamcinolone acetonide caused ocular hypertension in four
of the eight eyes, requiring surgical intervention in two.
Conclusion. A single infusion of infliximab should always be considered,
even as an adjunct therapy, for the control of acute panuveitis attacks
in BD.
ER -