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A three-centre experience with adalimumab for the treatment of non-infectious uveitis
  1. Bianca Carola Dobner1,
  2. Regina Max2,
  3. Matthias D Becker1,3,
  4. Carsten Heinz4,
  5. Ilka Veltrup4,
  6. Arnd Heiligenhaus4,
  7. Talin Barisani-Asenbauer5,
  8. Friederike Mackensen1
  1. 1Department of Ophthalmology, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany
  2. 2Department of Internal Medicine V/Rheumatology, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany
  3. 3Department of Ophthalmology, Triemli Spital, Zürich, Switzerland
  4. 4Department of Ophthalmology, Uveitis Center, St Franziskus Hospital, Münster, Germany
  5. 5Department of Ophthalmology and Optometrics, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Dr Bianca Carola Dobner, Department of Ophthalmology, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg 69120, Germany and Department of Ophthalmology, Dietrich Bonhoeffer Klinikum, 17033 Neubrandenburg, Germany; bianca.dobner{at}web.de

Abstract

Objective The aim of this study was to assess the efficacy of adalimumab in patients with active non-infectious uveitis in three different centres.

Methods In a retrospective study we identified patients from our databases who were treated with adalimumab. The composite outcome measure for efficacy included reduction of macular oedema by optic coherence tomography, visual acuity, anterior chamber cells, reduction of frequency of flares and reduction of prednisone dose during the treatment. At least one of the criteria had to be improved and none worsened to declare treatment as effective.

Results 60 patients with an average age of 37.3 years (range 4–71 years) were treated with adalimumab over an average follow-up period of 87.9 weeks (range 12–222 weeks). The indication for treatment was in 41 (68.3%) patients the activity of both uveitis and systemic disease and in 19 (31.7%) patients uveitis activity only. 15 (25%) patients were treated before with etanercept and 10 (16.7%) patients with infliximab. 49 out of 60 (81.7%) patients improved, while the other 11 (18.3%) patients did not meet improvement criteria and were given additional or alternative immunosuppressive treatment. At the last follow-up, 47 (78.3%) patients were still on adalimumab treatment. 13 (21.6%) patients stopped adalimumab treatment, due to inefficacy in eight, another three patients due to side effects (liver enzyme elevation and furunculosis), one patient due to pregnancy and one patient died.

Conclusions This large retrospective case series showed that adalimumab is effective in up to 80% of patients with uveitis.

  • Immunology
  • Inflammation
  • Treatment Medical
  • Pharmacology

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