دورية أكاديمية
أعرض في EDS

Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet's Disease.

التفاصيل البيبلوغرافية
العنوان: Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet's Disease.
المؤلفون: Martín-Varillas JL; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Calvo-Río V; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Beltrán E; Rheumatology and Ophthalmology, Hospital General Universitario de Valencia, Valencia, Spain., Sánchez-Bursón J; Rheumatology Hospital de Valme, Sevilla, Spain., Mesquida M; Rheumatology, Hospital Clinic, Barcelona, Spain., Adán A; Rheumatology, Hospital Clinic, Barcelona, Spain., Hernandez MV; Rheumatology, Hospital Clinic, Barcelona, Spain., Garfella MH; Rheumatology and Ophthalmology, Hospital General Universitario de Valencia, Valencia, Spain., Pascual EV; Rheumatology and Ophthalmology, Hospital Peset, Valencia, Spain., Martínez-Costa L; Rheumatology and Ophthalmology, Hospital Peset, Valencia, Spain., Sellas-Fernández A; Rheumatology Hospital Vall d'Hebron, Barcelona, Spain., Cordero-Coma M; Ophthalmology, Hospital de León, Léon, Spain., Díaz-Llopis M; Ophthalmology, Hospital Universitario La Fe, Valencia, Spain., Gallego R; Ophthalmology, Hospital Universitario La Fe, Valencia, Spain., Salom D; Ophthalmology, Hospital Universitario La Fe, Valencia, Spain., Ortego N; Ophthalmology and Autoinmune Disease, Hospital San Cecilio, Granada, Spain., García-Serrano JL; Ophthalmology and Autoinmune Disease, Hospital San Cecilio, Granada, Spain., Callejas-Rubio JL; Ophthalmology and Autoinmune Disease, Hospital San Cecilio, Granada, Spain., Herreras JM; Ophthalmology, Hospital Universitario, IOBA, Valladolid, Spain., García-Aparicio Á; Rheumatology, Hospital de Toledo, Toledo, Spain., Maíz O; Rheumatology and Ophthalmology, Hospital Donosti San Sebastian, Spain., Blanco A; Rheumatology and Ophthalmology, Hospital Donosti San Sebastian, Spain., Torre I; Rheumatology, Hospital Basurto, Bilbao, Spain., Díaz-Valle D; Rheumatology, Hospital Clínico San Carlos, Madrid, Spain., Pato E; Rheumatology, Hospital Clínico San Carlos, Madrid, Spain., Aurrecoechea E; Rheumatology, Hospital Sierrallana, Torrelavega, Spain., Caracuel MA; Rheumatology, Hospital de Córdoba, Córdoba, Spain., Gamero F; Rheumatology, Hospital San Pedro Alcántara, Caceres, Spain., Minguez E; Ophthalmology, Hospital Clínico de Zaragoza, Zaragoza, Spain., Carrasco-Cubero C; Rheumatology, Hospital de Mérida, Mérida, Spain., Olive A; Rheumatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Vázquez J; Rheumatology, Hospital de Ferrol, A Coruña, Spain., Ruiz-Moreno O; Rheumatology and Ophthalmology, Hospital Miguel Servet Zaragoza, Zaragoza, Spain., Manero J; Rheumatology and Ophthalmology, Hospital Miguel Servet Zaragoza, Zaragoza, Spain., Muñoz-Fernández S; Rheumatology, Hospital Universitario Infanta Sofía, en San Sebastián de los Reyes (Madrid), Madrid, Spain., Martinez MG; Rheumatology, Hospital Puerta del Mar, Cádiz, Spain., Rubio-Romero E; Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Toyos-Sáenz de Miera FJ; Rheumatology, Hospital Universitario Virgen Macarena, Sevilla, Spain., López Longo FJ; Rheumatology, Hospital Gregorio Marañón, Madrid, Spain., Nolla JM; Rheumatology, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain., Revenga M; Rheumatology, Hospital Universitario Ramón y Cajal, Madrid, Spain., González-Vela C; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Loricera J; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Atienza-Mateo B; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Demetrio-Pablo R; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Hernández JL; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., González-Gay MA; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. Electronic address: miguelaggay@hotmail.com., Blanco R; Rheumatology and Ophthalmology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
المصدر: Ophthalmology [Ophthalmology] 2018 Sep; Vol. 125 (9), pp. 1444-1451. Date of Electronic Publication: 2018 Mar 27.
نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : New York : Elsevier
Original Publication: Rochester, Minn., American Academy of Ophthalmology.
مواضيع طبية MeSH: Visual Acuity*, Adalimumab/*administration & dosage , Behcet Syndrome/*complications , Uveitis/*drug therapy, Adult ; Anti-Inflammatory Agents/administration & dosage ; Behcet Syndrome/drug therapy ; Dose-Response Relationship, Drug ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Uveitis/diagnosis ; Uveitis/etiology
مستخلص: Purpose: To assess efficacy, safety, and cost-effectiveness of adalimumab (ADA) therapy optimization in a large series of patients with uveitis due to Behçet disease (BD) who achieved remission after the use of this biologic agent.
Design: Open-label multicenter study of ADA-treated patients with BD uveitis refractory to conventional immunosuppressants.
Subjects: Sixty-five of 74 patients with uveitis due to BD, who achieved remission after a median ADA duration of 6 (range, 3-12) months. ADA was optimized in 23 (35.4%) of them. This biologic agent was maintained at a dose of 40 mg/subcutaneously/2 weeks in the remaining 42 patients.
Methods: After remission, based on a shared decision between the patient and the treating physician, ADA was optimized. When agreement between patient and physician was reached, optimization was performed by prolonging the ADA dosing interval progressively. Comparison between optimized and nonoptimized patients was performed.
Main Outcome Measures: Efficacy, safety, and cost-effectiveness in optimized and nonoptimized groups. To determine efficacy, intraocular inflammation (anterior chamber cells, vitritis, and retinal vasculitis), macular thickness, visual acuity, and the sparing effect of glucocorticoids were assessed.
Results: No demographic or ocular differences were found at the time of ADA onset between the optimized and the nonoptimized groups. Most ocular outcomes were similar after a mean ± standard deviation follow-up of 34.7±13.3 and 26±21.3 months in the optimized and nonoptimized groups, respectively. However, relevant adverse effects were only seen in the nonoptimized group (lymphoma, pneumonia, severe local reaction at the injection site, and bacteremia by Escherichia coli, 1 each). Moreover, the mean ADA treatment costs were lower in the optimized group than in the nonoptimized group (6101.25 euros/patient/year vs. 12 339.48; P < 0.01).
Conclusion: ADA optimization in BD uveitis refractory to conventional therapy is effective, safe, and cost-effective.
(Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
التعليقات: Erratum in: Ophthalmology. 2019 Jan;126(1):177. (PMID: 30577914)
المشرفين على المادة: 0 (Anti-Inflammatory Agents)
0 (Immunosuppressive Agents)
FYS6T7F842 (Adalimumab)
تواريخ الأحداث: Date Created: 20180401 Date Completed: 20190905 Latest Revision: 20190906
رمز التحديث: 20221213
DOI: 10.1016/j.ophtha.2018.02.020
PMID: 29602570
قاعدة البيانات: MEDLINE
الوصف
تدمد:1549-4713
DOI:10.1016/j.ophtha.2018.02.020