Randomized Controlled Study to Evaluate the Efficacy of Adalimumab in Patients with Different Forms of Refractory Uveitis.

Abstract

PURPOSE:

TNF alpha inhibitors have revolutionized the care of vision-threatening uveitis. This study evaluated the efficacy of adalimumab (ADA) for the treatment of refractory noninfectious uveitis.

DESIGN:

Randomized, prospective, controlled, two-center clinical trial Methods: Patients with active uveitis despite combined oral low-dose prednisolone and immunosuppression were randomized for additional ADA with corticosteroids in a fixed tapering regime, or corticosteroids only. Primary outcome measure at three months was improved best-corrected visual acuity (BCVA; >2 lines). In case of treatment failure, switch to the other arm was possible.

RESULTS:

Twenty-five patients (10 ADA, 15 controls) were included. BCVA increased with ADA by > 2 lines in 6/10 patients (60%; mean increase of 0.23 logMAR), but in only 2/15 from controls (13%, mean increase of 0.04 logMAR, Fisher´s exact test p = 0.00221).

CONCLUSIONS:

The results show superiority of ADA over controls in severe ocular inflammation including anterior uveitis.

• Authors: Friederike Mackensen, Carsten Heinz, Eva Jakob, Viviane Grewing, Hanns-Martin Lorenz, Arnd Heiligenhaus, Regina Max, Matthias D Becker
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 26 Issue 7 Pg. 1015-1022 ( 2018) ISSN: 1744-5078 [Electronic] England
• PMID: 29286865 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents
• Glucocorticoids
• Adalimumab

Topics

• Adalimumab (adverse effects, therapeutic use)
• Adult
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Male
• Prospective Studies
• Treatment Outcome
• Uveitis (classification, drug therapy, physiopathology)
• Visual Acuity