Behet disease with low response to several biological

Behçet disease with low response to several biological treatments, 4 years folow up Suhel Elnayef Barbara Delás Mouafk Asaad Consorcio Sanitario de Terrassa

Clinical Case A 28 years old male, from Morocco, attended our hospital for left eye pain, red eye and blurred vision with retroorbital headache without fever. - panuveitis on his right eye - oral and genital ulcers - knee arthritis Uncorrected VA: NLP / HM BMC: ● Right eye: cyclitic membrane. ● Left eye: keratic precipitates, tyndal ++, flare +++, remains of cyclitic membrane on crystalline and hematic color masses beyind cristalline.

Treatment ● Treatment : Anti-inflammatory and topical mydriatic. ● Internal medicina treatment: Prednisolona 90 mg/día sistémica, ciclosporina 100 mg/12 h, colchicina 1 mg/d. ● 3 m after : VA Left Eye 0. 1 (20/200). • • Partial resolution of synechiae, vitreous moderate fibrosis. Development of posterior subcapsular cataract , so operation was performed

Macular Edema after cataract surgery ● 6 m after IQ: • VA LE 0. 1 (20/100) • OCT: Cystoid macular edema 557 µm • Plan: Triamcinolone IV injection

Several outbreaks of CME in the folowing year

Starting Infliximab 5 mg/kg (10 dose in 1 year) 2 Outbreaks in 1 year

Starting Adalimumab 80 mg per month (1 year) 2 Outbreaks in 1 year

Starting tocilizumab 162 mg per week (1 year) 2 Outbreaks in 1 year

Starting Anakinra 100 mg/day (1 year) 2 Outbreaks in 1 year

Conclusions ● We noticed that the number of CMA outbreaks has decreased since begining of infliximab therapy ● The patient still have recurrent posterior uveitis (2 outbreaks per year) ● Changing biological therapy (infliximab, adalimumab, tocilizumab and anakinra) has not produced a decrease in the number of recurrences