AB1464 COMPARATIVE STUDY OF ADALIMUMAB, INFLIXIMAB AND CERTOLIZUMAB IN THE TREATMENT OF CYSTOID MACULAR EDEMA DUE TO BEHÇET’S DISEASE

Le résumé fourni par la source

Background the main cause of blindness in non-infectious uveitis is cystoid macular edema (CME). Behçet’s disease (BD) is one of the most common diseases associated with CME [1-3]. Objectives to compare efficacy and safety of Adalimumab (ADA), Infliximab (IFX) and Certolizumab (CZP) in refractory CME due to BD. Methods multicenter study of patients with CME secondary to BD refractory to glucocorticoids (GC) and at least 1 conventional immunosuppressant. All patients had CME (OCT>300µ) at baseline. From baseline up to 2 years, efficacy of ADA, IFX and CZP was assessed with the following ocular parameters: macular thickness (µm), visual acuity (BCVA), anterior chamber (AC) cells, vitritis and GC-sparing effect. Statistical analysis was performed with IBM SPSS Statistics v.23. Results a total of 50 patients (78 eyes) were considered. Twenty-five patients were treated with ADA, 15 patients with IFX and 10 patients were treated with CZP. No significant differences in demographic parameters were observed in the three groups. However, patients in the CZP group had a significantly longer time from diagnosis to drug initiation (75 [36-120] vs 30 [12-82] vs 15 [8-60] months; p=0.04) and received a greater median number of biological treatments (2 [0.75-3] vs 0 [0-0] vs 0 [0-0]) than the ADA and IFX groups. In CZP group, ADA and IFX were used previously in 7 patients. Combined therapy was used with ADA in 64%, with IFX in 66.7% and with CZP in 70% of CZP patients (p=0.94) (TABLE 1). Regarding efficacy outcomes, a rapid and maintained improvement in macular thickness was observed after 2 years of follow-up in three groups with no statistically significant differences between them (FIGURE 1). Improvement in BCVA, AC cells, vitritis and a GC-sparing effect was also noted. No serious adverse events were observed in IFX and CZP group. One case of pyelonephritis was reported in the ADA group. Conclusion ADA, IFX and CZP seem to be effective and safe in refractory CME due to BD. CZP appears effective even in patients with inadequate response to ADA and/or IFX. References [1]Martín-Varillas JL, et al. J Rheumatol. 2021;48:741-750. [2]Martín-Varillas JL, et al. Ophthalmology 2018; 125:1444-1451. [3]Martín-Varillas JL, et al. RMD Open 2022;8:e002693. Acknowledgements: NIL. Disclosure of Interests None Declared.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.