Infliximab versus adalimumab in the treatment of refractory inflammatory uveitis: Multicenter study from the french uveitis network

International audienceOBJECTIVES: To analyze the factors associated with response to anti-TNFα and to compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in patients with refractory non infectious uveitis.METHODS: Observational multicenter study including 160 patients [median age of 31 [21-42] years with 39% of men] with refractory uveitis treated with anti-TNFα [IFX 5mg/kg at weeks 0, 2, 6 and every 5-6 weeks (n=98) and ADA 40mg/14days (n=62)]. Factors associated to complete response were assessed in multivariate analysis. Comparison between efficacy and safety of IFX and ADA was performed using a propensity score approach accounting for baseline characteristics.RESULTS: Main etiologies of uveitis included Behçet's disease (36%), juvenile idiopathic arthritis (22%), spondylarthropathies (10%) and sarcoidosis (6%). The overall response rate at 6 and 12 months was of 87% (26% of complete response) and 93% (28% of complete response), respectively. The median time to complete response was 2 (0-12) months. In multivariate analysis, Behçet's disease (SHR= 2.52 [1.35-7.71], p=0.004) and a number of uveitis flares before anti-TNFα greater than 5 (HR=1.97 [1.02-3.84], p=0.045) were associated with complete response to anti-TNFα. Side effects were reported in 28% of patients, including 12% of serious adverse events. IFX and ADA did not differ significantly in terms of occurrence of complete response (SHR=0.65 [0.25;1.71], p=0.39), serious side effects (SHR= 0.22 [0.04-1.25], p=0.089) or event free survival (SHR=0.55 [0.28;1.08], p=0.083).CONCLUSIONS: Anti-TNFα are highly effective in refractory inflammatory uveitis. Behçet's disease is associated with increase odds of response. IFX and ADA seem equivalent in terms of efficacy. This article is protected by copyright. All rights reserve