Long-term Clinical Outcomes in Patients with Refractory Uveitis Associated with Behcet Disease Treated with Infliximab

Purpose: To assess long-term efficacy and safety of infliximab for refractory Behcet disease (BD) uveitis and to evaluate the effect of withdrawal of infliximab after achieving long-term remission. Methods: Retrospective study of 19 patients. Results: Mean follow-up was 44.1 +/- 36.5 months and mean number of infliximab infusions was 21.6 +/- 14.6. At end of follow-up, there was significant improvement of visual acuity and reduction of central macular thickness. All patients achieved remission, 14 of whom were able to discontinue corticosteroids. Ten patients developed autoantibodies and 1 patient developed infusion reactions. Eight eyes underwent intraocular surgery without exacerbation of quiescent uveitis. After achieving complete remission, 5 patients discontinued infliximab and maintained remission during a mean of 24.6 +/- 5.5 months. Conclusions: Infliximab is effective and safe for long-term treatment for refractory BD uveitis. Repeated infusions are required to maintain long-term remission, which may be sustained despite withdrawal of infliximab. Induction of autoantibodies is common.