title: Efficacy and safety of adalimumab in Behçet's disease-related uveitis: a multicenter retrospective observational study.
abstract: The study aim was to evaluate the efficacy of adalimumab (ADA) in a large series of Behçet's disease (BD)-related uveitis. We performed a multicenter retrospective observational study including 40 selected patients (66 eyes) receiving ADA. Clinical data were retrospectively analyzed at baseline, at 3 and 12 months of treatment. Primary end point was reduction of ocular inflammatory flares. Secondary end points were improvement of best corrected visual acuity (BCVA), reduction of macular thickness measured by optical coherence tomography (OCT), reduction in the occurrence of vasculitis assessed by fluorescein angiography (FA), and evaluation of statistically significant differences between patients treated with ADA monotherapy and those undergoing ADA plus DMARDs and in patients firstly treated with ADA compared to patients previously administered with other biologics; ADA steroid sparing effect was also evaluated. During the first 12 months of ADA therapy, the number of flares significantly decreased from 200 flares/100 patients/year to 8.5 flares/100 patients/year (p < 0.0001). Similarly, BCVA improved if compared to baseline (7.4 ± 2.9 versus 8.5 ± 2.1, p = 0.03). OCT findings significantly improved showing a mean reduction of central macular thickness (CMT) of 27.27 ± 42.8 μm at the end of follow-up (p < 0.006). FA identified retinal vasculitis in 22 cases at baseline (55%), 8 (20%) cases after 3 months, and in only one (2.5%) case at 12-month follow-up. FA improvement was highly significant at 3- and 12-month follow-up if compared to baseline (p < 0.0001 and p = 0.006, respectively). ADA is highly effective and safe for the treatment of BD-related uveitis, providing a long-term control of ocular inflammation.
authors.affiliation: Department of Ophthalmology, Humanitas Research Hospital, Rozzano, Milan, Italy. claudia.fabiani@gmail.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fabiani
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitale
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Emmi
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Vannozzi
authors.affiliation: Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lopalco
authors.affiliation: Department of Ophthalmology and Otolaryngology, Bari University, Bari, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Guerriero
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Orlando
authors.affiliation: Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Franceschini
authors.affiliation: Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Bacherini
authors.affiliation: Department of Ophthalmology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cimino
authors.affiliation: Department of Rheumatology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Soriano
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Frediani
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.affiliation: Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy.
authors.forename: Florenzo
authors.initials: F
authors.lastname: Iannone
authors.affiliation: Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Tosi
authors.affiliation: Department of Rheumatology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
authors.affiliation: Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage*; D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001528:Behcet Syndrome / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000150:complications / Q000188:drug therapy*; D014657:Vasculitis / Q000378:metabolism
chemical_list: D018501:Antirheumatic Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab
keywords: Adalimumab; Behçet’s disease; TNF-α inhibition; Treatment; Uveitis