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Peter G. Van Etten, T Missotten, P L. van Daele, G S. Baarsma, R W. Kuijpers, J A. van Laar, P M. van Hagen; Long Term Experience With Adalimumab for Uvetitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4256.
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To evaluate the longterm efficacy and safety of Adalimumab for non-infectious uveitis.
In this observational dynamic cohort 73 patients with refractory non-infectious uveitis who received subcutaneous Adalimumab in the period 2004 - 2010 were included. Refractory non-infectious uveitis was defined as failure on at least two other immunosuppressive drugs to control the uveitis episode or intolerance for current immunosuppressive drugs and/or failure to taper steroids. The visual acuity (VA), uveitis disease activity and cystoid macular edema (CME) were scored at a three months interval. Immunosuppressive co-medication and ocular surgery were allowed. Observed events during follow-up were registered and categorized in three groups: oncology related, infection related and miscellaneous.
142 eyes (73 patients, 41% man) were included. Mean age 40,4 years and mean follow up period 1.77 years (sd. 1.42). Mean VA at baseline was 0.48 logMAR (SEM 0.049; N=142), at 6 months 0,47 (SEM= 0.050; N=128), at 12 months 0,46 (SEM= 0.061; N=99) at 18 months 0,47 (SEM=0.075; N=76) and at 24 months 0,50 (SEM=0.093; N=49). Uveitis activity at baseline was present in 50,7% of patients and declined gradually (figuur 1). CME at baseline was present in 44.9% (SEM=0.042) and declined to 9% (SEM=0.043) at 24 months. Observed events: 5 infections with hospital admission, 1 malignancy (ovarian carcinoma), 8 others.
Subcutaneous adalimumab is an effective (steroid-sparing) therapy in patients with refractory non-infectious uveitis. It is well tolerated and a relatively safe immunosuppressive drug.
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