Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases
Authors: Belén Atienza‐Mateo, José Luis Martín‐Varillas, Vanesa Calvo‐Río, Rosalía Demetrio‐Pablo, Emma Beltrán, Juan Sánchez‐Bursón, Marina Mesquida, Alfredo Adan, María Victoria Hernández, Marisa Hernández‐Garfella, Elia Valls‐Pascual, Lucía Martínez‐Costa, Agustí Sellas‐Fernández, Miguel Cordero‐Coma, Manuel Díaz‐Llopis, Roberto Gallego, José L. García‐Serrano, Norberto Ortego‐Centeno, José M. Herreras, Alejandro Fonollosa, Ángel M. Garcia‐Aparicio, Olga Maíz‐Alonso, Ana Blanco, Ignacio Torre‐Salaberri, Cruz Fernandez‐Espartero, Vega Jovaní, Diana Peiteado, Esperanza Pato, Juan Cruz, Carlos Férnandez‐Cid, Elena Aurrecoechea, Miriam García‐Arias, Santos Castañeda, Miguel A. Caracuel‐Ruiz, Carlos A. Montilla‐Morales, Antonio Atanes‐Sandoval, Félix Francisco, Santos Insua, Senen González‐Suárez, Amalia Sanchez‐Andrade, Fernando Gamero, Luis F. Linares Ferrando, F. Romero‐Bueno, A. Javier García‐González, Raquel Almodóvar González, Enrique Minguez Muro, Carmen Carrasco‐Cubero, Alejandro Olive, Águeda Prior, Julio Vázquez, Oscar Ruiz‐Moreno, Fernando Jiménez‐Zorzo, Javier Manero, Santiago Muñoz Fernandez, Cristina Fernández‐Carballido, Esteban Rubio‐Romero, Fred Antón Pages, Francisco J. Toyos‐Sáenz de Miera, Myriam Gandia Martinez, David Díaz‐Valle, Francisco J. López Longo, Joan M. Nolla, Enrique Raya Álvarez, Marcelino Revenga Martínez, Julio José González‐López, Paz Rodríguez‐Cundin, José L. Hernández, Miguel A. González‐Gay, Ricardo Blanco
Journal: Arthritis & Rheumatology (2019)

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.