TY - JOUR T1 - Adalimumab for the treatment of refractory active and inactive non-infectious uveitis JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 1672 LP - 1678 DO - 10.1136/bjophthalmol-2017-311234 VL - 102 IS - 12 AU - Jonathan TL Lee AU - William B Yates AU - Sophie Rogers AU - Denis Wakefield AU - Peter McCluskey AU - Lyndell L Lim Y1 - 2018/12/01 UR - http://bjo.bmj.com/content/102/12/1672.abstract N2 - Background/aims To compare the efficacy of adalimumab in eyes with active and inactive non-infectious uveitis in the real-world setting.Methods Multicentre, retrospective, chart review of patients with refractory non-infectious uveitis treated with adalimumab. Main outcome measures included reduction of prednisolone dose, ability to taper immunosuppressives and a composite endpoint of treatment failure encompassing active inflammatory chorioretinal or retinal vascular lesions, intraocular inflammation grade and visual acuity.Results Thirty-seven eyes of 22 patients were studied. Mean follow-up was 20.1 months (median: 13). Most had either posterior or panuveitis (n=12, 55%). Mean duration of uveitis at baseline was 83.2 months (median: 61), where the majority (n=15, 68%) had already been treated with two or more conventional immunosuppressive agents in addition to prednisolone. Oral prednisolone was reduced to ≤10 mg/day in 9 of 12 patients (75%) by 6 weeks. At 6 months of therapy, nine (90%) of the active eyes achieved a 2-step improvement in anterior chamber inflammation, with six (60%) demonstrating a similar improvement in vitreous haze grade. Almost all (n=17, 94%) of the initially inactive eyes maintained clinical quiescence at this time point. The incidence rate of treatment failure during follow-up was 88 per 100 eye-years for the active eyes and 24 per 100 eye-years for the initially inactive eyes. There were no serious adverse effects.Conclusion Adalimumab appears to reduce the corticosteroid burden in active and inactive non-infectious uveitis in the real-world setting. Inflammatory activity at the time of adalimumab commencement may determine long-term treatment success. ER -