RESUMO
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.
Assuntos
Adalimumab/uso terapêutico , Síndrome de Behçet/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Imunossupressores/uso terapêutico , Infliximab/uso terapêutico , Uveíte/tratamento farmacológico , Adulto , Síndrome de Behçet/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Uveíte/etiologiaRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Condrocalcinose/induzido quimicamente , Condrocalcinose/diagnóstico por imagem , Pirofosfato de Cálcio/efeitos adversos , Esclerose/diagnóstico por imagem , Esteroides/uso terapêutico , Colchicina/uso terapêutico , Dor Lombar/etiologia , Diagnóstico Diferencial , Calcinose/diagnóstico por imagem , Calcinose/tratamento farmacológico , Condrocalcinose/tratamento farmacológico , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/patologiaAssuntos
Condrocalcinose/diagnóstico por imagem , Imageamento por Ressonância Magnética , Sacroileíte/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Condrocalcinose/complicações , Condrocalcinose/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Dor Lombar/etiologia , Pessoa de Meia-Idade , Sacroileíte/etiologia , Espondilartrite/diagnósticoRESUMO
No disponible
