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Miriam Allende, Lucia Ibares-Frias, Sonia Cecilia Labrador, Cristina Wong, Lidia Cocho, Jose Maria Herreras, ; Efficacy and safety of infliximab and adalimumab in treating ocular autoimmune diseases. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):862.
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To establish the efficacy and safety of the biological response modifiers (BRMs) infliximab and adalimumab in treating refractory ocular autoimmune disease.
Retrospective observational clinical analysis of case series of resistant autoimmune diseases from a single University Hospital which were treated with adalimumab or infliximab. All patients with intermediate uveitis were required to undergo magnetic resonance imaging of the brain to rule out demyelinating disease. Epidemiological data, data related to treatment with BRMs, other immunomodulatory adjuvant medications and other treatments for the control of the ocular pathology were collected from the beginning of the treatment with BRMs to the last visit closest to the 1st of July 2014. The main outcomes were: visual acuity, degree of anterior and posterior chamber inflammation (Standardization of Uveitis Nomenclature Working Group criteria), immunosuppression load (as defined by Nussenblat et al) and presence of complications. Student's dependent, independent t test or non-parametric test of Wilcoxon was used to make comparisons between means. Statistically significant differences were considered when p<0.05. Data were analyzed with SPSS 20 statistics software.<br />
31 patients, 13 men and 18 women were included. All patients had bilateral ocular involvement. The most common site of inflammation was the panuveitis (42.40%). Six patients were classified as having idiopathic forms of uveitis (19.35%). The most common diagnoses were Behçets disease (16.12%), HLA-B27 associated anterior uveitis (16.12%), Juvenile idiopathic arthritis (12.90%) and Vogt-Koyanagi-Harada (12.90%). There were improvements in the parameters analyzed in most patients with statistically significant results in the reduction of the immunomodulatory load with infliximab, reduction of cells in the anterior chamber and reduction of immunomodulatory load with adalimumab. Infliximab outperformed adalimumab in the first 24 months of use and adalimumab until the end of the study, in certain specific uveitis. Complications were observed in 14.70% of patients.<br />
Infliximab and adalimumab are both effective and safe drugs for resistant uveitis and may reduce immunomodulation requirement. However, there are slight differences between the two treatments that should be considered.<br />
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