Long-term efficacy of early infliximab-induced remission for refractory uveoretinitis associated with Behcet's disease.

BACKGROUND: To evaluate long-term efficacy of infliximab (IFX) in refractory uveoretinitis associated with Behcet's disease (BD) depending on uveoretinitis duration. METHODS: Records of 16 patients with BD (32 eyes) followed for >5 years after starting IFX, were retrospectively reviewed. Long-term efficacy was compared between patients with short duration (</=18 months, n=7) versus long duration (>18 months, n=9) of their uveoretinitis prior to starting IFX. RESULTS: The median follow-up after starting IFX was 132 months (76-146 months). Mean frequency of attacks and the 1-year Behcet's Disease Ocular Attack Score 24 decreased significantly over 10 years. Overall, the percentage of eyes with a best-corrected visual acuity (BCVA) >/=1.0 increased from 47% at baseline to 59% at 5 years; the percentage of eyes with a BCVA </=0.1 was 19% at both baseline and 5 years. The frequency of ocular attacks decreased similarly in both short duration and long duration groups; however, the percentage of eyes with a BCVA >/=1.0 at 5 years was 100% in the short duration group versus 28% in the long duration group. IFX was discontinued in four patients with an excellent response to IFX therapy; all were young male patients in the short duration group with good BCVA bilaterally, and none had inflammatory recurrences over a median follow-up of 56 months off IFX. CONCLUSION: Initiation of IFX therapy in patients with BD within 18 months of their uveoretinitis onset was more effective in maintaining good BCVA than after 18 months.