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Interleukin (IL)-1 inhibition with anakinra and canakinumab in Behçet’s disease-related uveitis: a multicenter retrospective observational study

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Abstract

This study aimed to evaluate the role of interleukin (IL)-1 inhibitors anakinra (ANA) and canakinumab (CAN) in the treatment of Behçet’s disease (BD)-related uveitis. Multicenter retrospective observational study includes 19 consecutive BD patients (31 affected eyes) received treatment with anti-IL-1 agents. Data were analyzed at baseline and at 3 and 12 months. The primary endpoint is the reduction of ocular inflammatory flares (OIF). The secondary endpoints are improvement of best corrected visual acuity (BCVA); reduction of macular thickness defined by optical coherence tomography (OCT) and of vasculitis identified with fluorescein angiography (FA); evaluation of statistically significant differences between patients treated with IL-1 inhibitors as monotherapy, subjects also administered with disease modifying anti-rheumatic drugs (DMARDs) and/or corticosteroids as well as between patients administered with IL-1 inhibitors as first line biologic treatment and those previously treated with TNF-α inhibitors. At 12 months, OIF significantly decreased from 200 episodes/100 patients/year to 48.87 episodes/100 patients/year (p < 0.0001). The frequency of retinal vasculitis identified by FA significantly decreased between baseline and 3- and 12-month follow-up visits (p < 0.0001 and p = 0.001, respectively). OIF rate was significantly higher in patients co-administered with DMARDs (81.8 episodes/100 patients/year) than in patients undergoing IL-1 inhibitors as monotherapy (0.0 episodes/100 patients/year) (p = 0.03). No differences were identified on the basis of corticosteroid use and between patients administered with IL-1 inhibitors as first line biologic approach or second line. Steroid dosage was significantly decreased at 12-month visit compared to baseline (p = 0.02). Treatment with IL-1 inhibitors is effective in the management of BD-related uveitis and provides a long-term control of ocular inflammation in refractory and long-lasting cases.

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Authors and Affiliations

  1. Department of Ophthalmology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy

    Claudia Fabiani

  2. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy

    Antonio Vitale, Stefano Gentileschi, Bruno Frediani, Mauro Galeazzi & Luca Cantarini

  3. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Giacomo Emmi

  4. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy

    Giuseppe Lopalco & Florenzo Iannone

  5. Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy

    Lorenzo Vannozzi & Daniela Bacherini

  6. Department of Ophthalmology and Otolaryngology, Bari University, Bari, Italy

    Silvana Guerriero

  7. Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy

    Rossella Franceschini & Gian Marco Tosi

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  1. Claudia Fabiani
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Correspondence to Claudia Fabiani.

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Fabiani, C., Vitale, A., Emmi, G. et al. Interleukin (IL)-1 inhibition with anakinra and canakinumab in Behçet’s disease-related uveitis: a multicenter retrospective observational study. Clin Rheumatol 36, 191–197 (2017). https://doi.org/10.1007/s10067-016-3506-4

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  • DOI: https://doi.org/10.1007/s10067-016-3506-4

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