Author: Olivia Schatz
Co-authors: Sophie Beka, Markus Eidherr, Matthias Bolz, Rupert W. Strauss
Abstract
Purpose:Non-infectious uveitis comprise a group of inflammatory and immune-mediated diseases that are treated with local and/or systemic steroid therapy as first line treatment. However, the course may also require long-term immunosuppression with second-line-disease-modifying antirheumatic drugs (DMARDs) to reduce systemic cortisone dosage. Adalimumab was approved for the treatment of anterior uveitis in children and intermediate and posterior uveitis in adults in Europe in 2016. The aim of the study is to evaluate the effectiveness of adalimumab for reaching quiescence and saving systemic cortisone.
Setting/Venue:
Patients treated with adalimumab due to non-infectious uveitis at the Department of Ophthalmology, Kepler University Clinic Linz (Linz, Austria) between 2016 and 2022 were included in this retrospective analysis.
Methods:
The primary endpoint of the study was quiescence, defined as the absence of inflammatory cells and/or flare in the anterior chamber and vitreous body and/or the absence of inflammatory vascular changes of active chorioretinal inflammation, depending on the form of uveitis. Furthermore, reaching steroid dosages below the Cushing threshold dosages of 7.5 mg were assessed. Demographic data (age, sex) and clinical data (BCVA, clinical findings, central retinal thickness determined by optical coherence tomography (OCT) were collected for this purpose. Disease activity was determined according to standardization of uveitis nomenclature. Visual acuity was converted into LogMar for statistical purposes.
Results:
Fifty-five eyes (28 right, 27 left) of 28 patients (12 male, 16 female) were included. The median age at first visit was 43 years. Six eyes had chronic anterior uveitis, 27 had intermediate, 21 had posterior, and one had panuveitis. After 12 months, 7 eyes showed an anterior chamber inflammation of ³ SUN 0.5, nine eyes flare of ³ SUN 0.5, and 11 eyes vitreous cells. The mean visual acuity was 0.38 ±0.68 LogMar, none of the patients required prednisolone doses ³7.5 mg after 12 months.
Conclusions:
Adalimumab shows a safe application profile in the clinical routine in this patient cohort and proves to be a potent DMARD for the control of non-infectious uveitis. The inflammatory activity can be controlled well and daily dosages ³7.5 mg of systemic prednisolone are necessary.
Financial Disclosure:
There was no financial support to conduct this study. None of the authors has a conflict of interest to declare.
