Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Adalimumab in 107 Refractory Uveitis: A Multicenter Study.

Pompei1,  Orlando, Blanco2,  Ricardo, Diaz-llopis3,  Manuel, Salom3,  David, Garcia-Vicuna4,  Carmen, Cordero-Coma5,  Miguel, Ortega-Larrocea6,  Gabriela

Hospital Universitario Marqués de Valdecilla. IFIMAV, Santander, Spain
Hospital de Cruces, Bilbao, Spain
Hospital Virgen de la Salud, Toledo, Spain
Hospital Clínico San Carlos, Madrid
Hospital Son Dureta, Palma de Mallorca, Spain
Ophthalmology Clinic Center of Caracas, Caracas, Venezuela
Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
La Fe University Hospital of Valencia, Valencia, Spain
Hospital Sant Joan de Déu, Barcelona, Spain
Hospital de León, León, Spain
National Institute of Rehabilitation, D.F Mexico, Mexico
Hospital Clínico San Cecilio, Granada, Spain
Hospital Ramon y Cajal, Madrid, Spain
Hospital de Pontevedra, Pontevedra, Spain

Background/Purpose:

To assess the efficacy and safety of adalimumab therapy in refractory autoimmune uveitis.

Methods:

Retrospective, multicenter study on 107 patients. All of them had a failure or intolerance of prednisone therapy and >=1 other systemic immunosuppressive therapy. Different etiologies were diagnosed: Juvenile Idiopathic Arthritis (40 cases, 37%), uveitis of Idiopathic origin (20 cases, 19%), Pars Planitis (14 cases, 13%), Behçet Disease (11 cases, 10%), Vogt Koyanagy Harada syndrome (7 cases, 7%), Ankylosing Spondylitis (5 cases, 5%), Inflammatory Bowel Disease (2 cases, 2%), Birdshot Coriorretinopathy (1 case, 1%), Rheumatoid Arthritis (1 case, 1%), Multifocal choroiditis with panuveitis (1 case, 1%), Sarcoidosis (1 case, 1%), Sympathetic Ophthalmia (1 case, 1%), and others (2%). Adalimumab (40 mg subcutaneously) every-other-week was maintained during 6 months. If uveitis was inadequately controlled, the Adalimumab dosage was increased up to 40 mg/wk. All patients underwent an outcome assessment at month 6.

Results:

107 patients (45 males, 62 females), mean age 25.23±17.68 years (range: 4 to 65 years), with active intraocular inflammation at baseline were studied. Thirty-eight had inflammation in the anterior camera, and following Adalimumab therapy achieved significant improvement (mean tyndall improved from 1.43±0.9 to 0.2±0.4; p<0.0001. Also, 54 patients had inflammation in the posterior camera. Significant improvement of optic coherence tomography (OCT) was achieved: baseline; 332.35±137.62 microns; and after 6 months of Adalimumab treatment 244.56±34.17 microns; p<0.0005. Also, 16 patients had cystoid macular edema (CME): at baseline mean OCT 432.81±144.21 microns, and after Adalimumab 256.25±37.36 microns; p<0.0003. Most of the remaining patients with intermediate uveitis (15 cases) had improvement. Also, most patients were able to reduce at least 50% of the dose of the concomitant immunosuppressive drugs at the end of follow-up. Adalimumab was usually well tolerated, and only local minor side effects at the injection site were observed. Nevertheless, 11 patients (10%) had moderate to severe relapses during the follow-up period, and 28 patients (26%) had minor relapses during the follow-up that were controlled with 1 periocular steroid injection.

Conclusion:

Adalimumab appears to be an effective and safe treatment for refractory uveitis and may reduce steroid requirement. However, further controlled studies of adalimumab for uveitis are warranted.

To cite this abstract, please use the following information:
Pompei, Orlando, Blanco, Ricardo, Diaz-llopis, Manuel, Salom, David, Garcia-Vicuna, Carmen, Cordero-Coma, Miguel, et al; Adalimumab in 107 Refractory Uveitis: A Multicenter Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1045
DOI:

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