SAT0264 LONG TERM FOLLOW-UP AND OPTIMIZATION OF INFLIXIMAB IN REFRACTORY UVEITIS DUE TO BEHÇET’S DISEASE. MULTICENTER STUDY OF 103 CAUCASIAN PATIENTS
Authors: J. L. Martín-Varillas, B. Atienza-Mateo, V. Calvo-Río, E. Beltrán, A. Adan, E. Aurrecoechea, S. Castañeda, M. A. González-Gay, J. L. Hernández, R. Blanco
Journal: Annals of the Rheumatic Diseases (2020)

Background: Biologic therapy has improved prognosis of Behçet Disease (BD) uveitis (1-5). Although infliximab (IFX) is approved in Japan, most data in Caucasian patients comes from small series. No data on optimization has been published Objectives: In a large series of Caucasian patients with refractory uveitis of BD, we assess: a ) long-term efficacy and safety; b ) IFX optimization when ocular remission was achieved Methods: Multicenter study of IFX-treated patients with BD uveitis refractory to conventional immunosuppressants.103 patients were treated with IFX as 1st biologic as follows: 3-5 mg/kg i.v. at 0, 2, 6 and every 4-8 weeks. The main outcomes were anterior chamber cells, vitritis, retinal vasculitis, macular thickness, visual acuity, and glucocorticoids sparing effect; analysed at baseline, 1st week, 1st and 6th months and 1st and 2nd years. After remission, IFX optimization was performed Results: In whole series (n=103), main outcomes showed a rapid and maintained improvement, reaching remission in 78 patients after a mean IFX duration of 31.5 months. Severe side-effects were observed in 9 patients. Comparative study between optimized and non-optimized groups showed: a ) no differences in clinical baseline characteristics; b ) similar maintained improvement in most ocular outcomes; c ) lower severe adverse events and d ) lower IFX cost in optimized group (4826.52 vs 9854.13 euros/patient/year) (Table ) Conclusion: IFX seems effective and safe in Caucasian patients with refractory BD uveitis. IFX optimization is effective, safe, and cost-effective References: [1]Martín-Varillas JL. Ophthalmology 2018;125:1444-1451. [2]Atienza-Mateo B: Arthritis Rheumatol. 2019;71:2081-2089 [3]Santos-Gómez M. Clin Exp Rheumatol. 2016;34 (6 Suppl 102): S34-S40 [4]Urruticoechea-Arana A. Rheumatol Int. 2019;39:47-58. [5]Atienza-Mateo B. Rheumatology (Oxford). 2018 1;57:856-864 Table. Optimized N=18 Non Optimized N=42 P Patients/eyes affected, n/n 18/34 42/77 Age, mean (SD), years 39.5 (9.8) 38.8 (10.5) 0.82 Men, % 55.6 59.5 0.78 Duration of uveitis before IFX, median [IQR] months 38 [18-119] 35 [10-48] 0.11 Ocular features at time of IFX onset -AC cells count, median [IQR] 2 [1-4] 2 [1-2] 0.29 -Vitritis, median [IQR] 2 [1.5-3] 2 [1-2] 0.02 -BCVA, mean (SD) 0.32 (0.21) 0.37 (0.26) 0.51 -OCT, mean (SD) 303.5 (23.3) 397.7 (155.7) 0.12 -Retinal vasculitis, n (%) 9 (50) 26 (66.7) 0.23 Uveitis pattern, n (% ) -Bilateral/unilateral 16/2 (88.9/11.1) 35/7 (83.3/16.7) 0.71 -Anterior 0 (0) 6 (14.3) 0.17 -Posterior 5 (27.8) 8 (19.0) 0.50 -Panuveitis 13 (72.2) 28 (66.7) 0.67 Prednisone dose at IFX onset, mean (SD), mg/d 40.3 (20.6) 41.4 (15.5) 0.81 IFX therapy Monotherapy/combined treatment, n (%) 15 (83.3) 30 (71.4) 0.33 -AZA 5 (27.8) 4 (9.5) 0.11 -CsA 9 (33.3) 8 (19.0) 0.32 -MTX 4 (22.2) 15 (35.7) 0.30 Follow-up on IFX therapy, median [IQR], months 48 [33-60] 24 [6-60] 0.007 - Relapses, median (IQR ) 0 [0-1] 0 [0-2] - Remission, % 100 75.6 0.46 - Severe side effects, n (per 100 patients/year ) 0 (0) 3 (0.78) 0.02 - Cost (mean), euros per year 4826.52 9854.13 0.55– Disclosure of Interests: José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Belén Atienza-Mateo: None declared, Vanesa Calvo-Río Grant/research support from: MSD and Roche, Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Emma Beltrán: None declared, Alfredo Adan: None declared, Elena Aurrecoechea: None declared, Santos Castañeda: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, J. Luis Hernández: None declared, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD