Long-term efficacy of infliximab treatment and the predictors of treatment outcomes in patients with refractory uveitis associated with Behçet’s disease

Abstract

Objective: To assess the long-term efficacy and safety of infliximab (IFX) treatment for refractory uveitisassociated with Behçet’s disease (BD) and to identify predictors of long-term IFX therapy outcomes.Methods: We retrospectively studied 44 consecutive BD patients with uveitis who were started on IFXtherapy and analyzed the efficacy and safety of IFX and the treatment continuation rate. To determinepredictors of IFX responsiveness, we analyzed the clinical characteristics of the patients who receivedregular maintenance therapy and those who required treatment intensification. The serum cytokinelevels prior to IFX were measured through the Bio-Plex human cytokine assays.Results: IFX significantly reduced the frequency of ocular attacks and improved the visual acuity of pa-tients with BD-related uveitis. However, approximately half of the patients required dose escalations,necessitating a shortening of the intervals between IFX infusions due to loss of efficacy during the5-year treatment. The frequency of ocular attacks was significantly higher in patients with completeBD than in patients with incomplete BD. A multiplex cytokine analysis revealed that patients withBD-related uveitis exhibited increased serum IL-2, IL-6, IL-8, and MCP-1 levels. Moreover, among BDpatients, the serum IL-2 and IL-6 levels were particularly high in those who maintained remission andreceived regular IFX treatments.Conclusion: We confirmed the long-term efficacy and tolerability of IFX in patients with BD-relateduveitis. Our results indicate that complete BD may be less responsive to IFX and that the pretreatmentserum cytokine profiles may be useful for predicting the long-term IFX therapy outcomes.