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A. I. Al Hemidan, K. F. Tabbara; Long Term Effect of Infliximab in Resistant Cases of Behcets Disease. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5132.
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Behcet’s disease is a chronic multi-system disorder characterized by recurrent episodes of uveitis, genital ulcers, oral lacerations and skin lesions. We studied the long-term effects of infliximab ( anti-tumor necrosis factor α antibody) in the management of patients with Behcet’s disease who were resistant to convetional immunosuppressive therapy.
10 patients with complete Behcet’s disease were included. All patients had the four major criteria. Each patient underwent complete eye examination, flourescein angiography and laboratory investigations. Patients who were resistant to conventional immunosuppressive agents were included. Infliximab was given at a dosage level of 5mg/kg in a single intravenous infusion over a period of three hours. Infliximab was then given once every two weeks. Patients were examined before 3 and 7 days after treatment, at weekly interval for a period of three months, and monthly thereafter. The following parameters were monitored; visual acuity, anterior chamber flare and cells, vitreous exudates, presence or absence of retinal vasculitis, papillitis. Laboratory investigations were done to monitor the side effects of Infliximab.
The age range was 16 to 30 years with a mean age of 24.5 years. The follow-up period ranged from 1 to 6 years. The mean follow-up period was 3.5 years. Fourteen (70%) eyes had a final visual acuity of 20/50 or better and 6 (30%) eyes had a final visual acuity of < 20/50. Four eyes had evidence of optic atrophy, one had macular hole and one patient had bilateral glaucoma and cataract.
Infliximab is safe and effective in the long-term management of patients with Behcet’s disease who were resistant to conventional immunosuppressive therapy. Amelioration of the signs and symptoms and improvement in visual acuity were noted. Long term remission in patients with Behcet’s disease is highly desirable to prevent the irreversible complications that may eventuate in loss of vision.
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