Infliximab in the treatment of posterior uveitis in Behçet's disease. Long term follow up in four patients.

Lanthier, Nicolas [UCL] Parc, Christine [Hôpital Cochin] Scavennec, Rodolphe [Hôpital Cochin] Dhôte, Robin [Hôpital d'Avicenne] Brézin, Antoine [Hôpital Cochin] Guillevin, Loïc [Hôpital Cochin] et al.

OBJECTIVE: To evaluate the efficacy of infliximab as adjuvant therapy for refractory uveitis in Behçet's disease. METHODS: Retrospective evaluation of 4 patients with Behçet's disease and severe uveitis, refractory to conventional corticosteroid and immunosuppressant regimens, to which infliximab (anti-tumor necrosis factor-alpha (TNFalpha) antibodies) was added. The outcome measures were intraocular inflammation, visual acuity, reduction of daily corticosteroid dose, and adverse effects. RESULTS: The mean follow-up period was 11 months (range: 2-29 months). Patients received a mean of 8 (range: 3-16) infliximab infusions. TNFalpha blockade with infliximab was effective for 2 of our 4 patients: the effect for them was rapid but transient. One patient experienced a thoracic herpes zoster, a severe adverse effect not previously reported. CONCLUSIONS: Response to infliximab was variable in patients with Behçet's disease for whom conventional immunosuppression had failed. Infliximab allowed the daily corticosteroid dose to be reduced for some patients but required repeated infusions.