Adalimumab therapy for refractory uveitis: a pilot study.
OBJECTIVE
The aim of this study was to assess the efficacy and safety of adalimumab in treating refractory autoimmune uveitis.


METHODS
This work was a prospective, noncomparative, nonrandomized, clinical trial. Nineteen (19) patients meeting eligibility criteria received a 40-mg subcutaneous (s.c.) injection of adalimumab every other week during 1 year.


RESULTS
All patients underwent an outcome assessment at month 12. Visual acuity improved by -0.3 logMar in 12 (31%) eyes of 38, and worsened by +0.3 logMar in 1 (2.6%) eye. All patients had an active intraocular inflammation at baseline, and 12 patients (63%) achieved control of their inflammation with adalimumab at the end of follow-up. After optic coherence tomography, 33 eyes (86%) had cystoid macular edema (CME) at baseline, and at the end of follow-up there was a complete resolution of CME in 18 of these 33 eyes (54.54%). All patients were able to reduce at least 50% of the dose of the concomitant immunosuppressive drugs at the end of follow-up. Adalimumab was well tolerated in all patients, and only local minor side effects at the s.c. injection site were observed. Nevertheless, 8 patients (42.10%) had relapses during the follow-up period that were controlled with 1 periocular steroid injection.


CONCLUSIONS
Adalimumab seems to be an effective, safe therapy for the management of refractory uveitis and may provide the possibility to reduce the concomitant immunosuppressive drugs in these patients. Further long-term studies are warranted to determine the safety and efficacy of adalimumab in treating intraocular inflammation.
Diaz-Llopis
Manuel
M
Uveitis and Retina Unit, Department of Ophthalmology, University General Hospital of Valencia, Valencia, Spain. manuel.diaz@uv.es
García-Delpech
Salvador
S
Salom
David
D
Udaondo
Patricia
P
Hernández-Garfella
Marisa
M
Bosch-Morell
Francisco
F
Quijada
Arturo
A
Romero
Francisco J
FJ
D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001327:Autoimmune Diseases / Q000188:drug therapy; D004351:Drug Resistance; D005123:Eye / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007279:Injections, Subcutaneous; D008269:Macular Edema / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000503:physiopathology; D014787:Vision Tests; D014792:Visual Acuity / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068879:Adalimumab