Timing of recurrent uveitis in patients with Behcet's disease receiving infliximab treatment

Aim To investigate the relationship between recurrence of uveitis and timing of infliximab in patients with Behcet's disease. Methods Charts were retrospectively reviewed for 23 patients with refractory uveoretinitis associated with Behcet's disease treated using infliximab at our hospital. Infliximab was administered by intravenous infusion at weeks 0, 2 and 6, and every 8 weeks thereafter. The relationship between recurrence of uveitis and infliximab infusion was analysed. Results Mean duration of infliximab treatment for the 23 patients was 20 months, and the mean number of infliximab infusions was 12. Recurrent uveitis was seen during treatment in 13 of 23 patients, with no recurrences in the remaining 10 patients. Two patients developed recurrence soon after starting treatment-for example, first recurrence after starting infliximab was on day 19 or day 29, but the other 11 patients experienced recurrences after 5-6 months of infliximab treatment. As regards the timing of recurrences following infliximab infusion, 10 of the 13 patients developed recurrences similar to 5 weeks after infliximab infusion. Recurrent uveitis in these patients most often occurred during weeks 7-8 after infusion. However, three of the patients developed recurrent uveitis at various times, for example in weeks 1, 4, 7 and 8 after infliximab infusion. Conclusion Infliximab is effective for suppressing recurrence of uveitis in Behcet's disease, but responses to infliximab differ among patients. Careful observation following infliximab infusion is necessary to manage the recurrence of uveitis during treatment.