Purpose: To investigate the treatment outcomes with adalimumab administration for noninfectious uveitis and to analyze the clinical characteristics of the non-responders and responders to the treatment.
Patients and methods: A retrospective evaluation was performed for 44 eyes from 25 patients with noninfectious uveitis who visited Japan Community Health care Organization Osaka Hospital between January 1, 2017 and December 31, 2018, and were able to receive adalimumab for at least 6 months. Changes in age, sex, causative disease, and duration of disease; intraocular inflammation from the start of treatment to 6 months; and changes in prednisolone and other combined treatments were evaluated, and patients were classified into two groups of non-responders and responders to the treatment. The criteria for responders included any improvement and no worsening.
Results: Responses to adalimumab administration were observed in 20 out of 25 patients (80%). Six months after the initiation of treatment, visual acuity (p=0.03) and anterior chamber inflammation (p=0.0006) significantly improved, but vitreous opacity and retinal edema did not. Univariate regression analysis showed that no concomitant medications other than prednisolone (p=0.01) and longer disease duration (p=0.02) were significantly associated with non-response to adalimumab treatment. Age and prednisolone dose were not associated with the efficacy of adalimumab.
Conclusion: Adalimumab is effective in noninfectious uveitis in 80% of patients, but it may not be effective in patients treated with prednisolone alone or in patients with long-term disease.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 424-431, 2020.