RT Journal Article
SR Electronic
T1 Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
JF BMJ Open Ophthalmology
JO BMJ Open Ophth
FD BMJ Publishing Group Ltd
SP e000819
DO 10.1136/bmjophth-2021-000819
VO 6
IS 1
A1 Tang Lee Say, Timothy Lee
A1 Yang, Verlyn
A1 Fingret, Jacob M
A1 Zagora, Sophia
A1 Symes, Richard
A1 Younan, Christine
A1 Cornish, Elisa Eleanor
A1 Verma, Nitin
A1 Sammel, Anthony
A1 Wakefield, Denis
A1 Speden, Deborah
A1 McCluskey, Peter J
YR 2021
UL http://bmjophth.bmj.com/content/6/1/e000819.abstract
AB Objectives Biologics are rapidly emerging as an effective vision saving addition to systemic uveitis therapy. The aim of this multicentre retrospective study is to review the outcomes of a large group of patients treated with adalimumab.Methods A retrospective chart review of patients with refractory non-infectious, active uveitis treated with adalimumab was conducted. The main outcome measures were ability to reduce prednisolone dose, ability to control uveitis, final visual acuity and time to treatment failure.Results Forty-six patients with uveitis, treated with adalimumab were included in the study. The most common anatomical uveitis phenotype was panuveitis (n=17, 37.0%). The most common diagnosis was idiopathic uveitis (n=19, 41.3%). At their latest review (mean: 4.46 years; median 4.40 years), 35 (76.1%) patients were able to discontinue corticosteroids, 11 (23.9%) patients were able to taper to <7.5 mg/day and only 1 (2.2%) patient required 10 mg of prednisone. The mean visual acuity at the latest follow-up of the worse eye was logarithm of the minimum angle of resolution (logMAR) 0.42 (SD 0.72), while the mean visual acuity of the better eye was logMAR 0.19 (SD 0.34). Of the 89 eyes, 21 (23.6%) eyes improved by at least 2 lines, 5 eyes (5.6%) deteriorated by ≥2 lines while vision was unchanged in the remaining 63 (70.8%) eyes. The time to recurrence was 1 in 12.47 person-years for adalimumab, with a 17.4% (8 patient) relapse rate. There were no serious adverse events.Conclusions This study highlights the efficacy of adalimumab in patients with vision-threatening non-infectious uveitis, preserving vision and allowing reduction of corticosteroid dose.Data are available on reasonable request. All clinical data can be found in the record sections of Sydney Eye Hospital, St. Vincent’s Hospital Sydney and Royal Hobart Hospital.