Patients With Noninfectious Uveitis Likely to Achieve Disease Control Using Adalimumab

Adalimumab (ADA) can effectively treat chronic noninfectious uveitis (NIU), according to a retrospective review of patient records published in Acta Ophthalmologica.

Patients (N=51) who received 12 months of ADA treatment for chronic NIU between 2016 and 2020 at the Manchester Royal Eye Hospital in the UK were retrospectively reviewed for ophthalmologic and visual outcomes.

Participants (mean age 48.3±11.72 years, 27.3% women) had uveitis for a median of 7 years (range, 2-35 years), 39.2% had active inflammation, and baseline best corrected visual acuity (BCVA) was 0.3 (range, -0.1 to 0.3) logMAR.

At 12 months, patients reduced their prednisolone dose from 10.0 mg per day to 5.0 mg per day and their BCVA from 0.3 logMAR to 0.2 logMAR. Similar trends were observed among the subset of eyes with active NIU at baseline.

Central retinal thickness decreased from 310.98±124.54 μm at baseline to 261.38±84.94 μm at 12 months. Central retinal thickness significantly decreased among the subset of eyes with cystoid macular edema (n=28; P <.001). Intraocular pressure (IOP) decreased from 14.83±5.21 mm Hg to 14.64±4.9 mm Hg.

At 6 months, treatment had failed in 10 eyes and at 12 months, 20 eyes. Treatment failed due to worsening visual acuity (n=17), macular edema (n=7), cataract (n=6), or other reasons (n=6).

Anterior chamber cells-defined failure occurred in 2 eyes by 6 months, due to vitreous haze.

The only clinical feature associated with treatment failure at 12 months was need for rescue medication 12 months before receiving ADA therapy (OR, 0.22; 95% CI, 0.05-0.89; P =.03).

No serious adverse events, infections, allergic reactions, or hospitalizations were reported. Two patients discontinued treatment due to inefficacy.

This study was limited by its retrospective design and these findings may not be generalizable, as these patients were severe cases with previous treatment failures.

“Patients with chronic NIU who received ADA therapy for 12 months were likely to achieve disease control, stabilize or improve visual acuity, experience a reduction of immunosuppressive therapies and reduce corticosteroid dosage,” researchers report. “No new safety events were observed.”

Reference

Leal I, Wong SW, Giuffre C, et al. Real-world outcomes of adalimumab in adults with non-infectious uveitis. Acta Ophthalmol. Published online March 11, 2022. doi:10.1111/aos.15120