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Emanuela Interlandi, Valentina Di Iorio, Raffaele Perrotta, Loredana Latanza; Adalimumab For Treatment Of Severe Uveitis Associated To Behçet Disease. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5494.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effectiveness and safety of Adalimumab therapy in patients affected by refractory Behçet-related uveitis
Twelve affected patients (22 eyes) were retrospectively analised after an informed consent was obtained from all of them. All patients received 40 mg of Adalimumab subcutaneously, once every 2 weeks, in addition to traditional immunosuppressive therapy; in all cases Adalimumab was administrated since ocular inflammation did not respond to traditional immunosuppressants and eight of them were switched to Adalimumab after failure of Infliximab therapy. The mean follow-up was 19,92 months (±6,92 SD; range:8-34). Main outcome measures included changes of best corrected visual acuity (BCVA), uveitis attacks and daily steroids dose in addition to uveitis remission and occurrence of Adalimumab-related side effects. Pre-Adalimumab period was defined as a span of time, before Adalimumab administration, correspondent to follow-up period for each patient.
Mean age of patients (11 males and 1 female) was 32,75 years (± 10,63 SD; range: 13-58), while mean uveitis duration was 7,5 years (± 4,46 SD). Seven patients (58%) were positive to HLA-B51 antigen. Ocular involvment resulted bilateral in 83% of cases and mainly consisted in panuveitis (68% of eyes). During Adalimumab therapy all patients but one (91%) achieved uveitis remission associated to a visual acuity improvment, at least in one eye, in all of them. Mean BCVA improved from 0.45 logMAR at baseline to 0.24 logMAR (p = 0.026), during Adalimumab therapy, in the worse eye. In all Adalimumab responders daily steroids were gradually tapered up to suspension in 73% of them. Mean uveitis attacks per patient decreased from 2,18, during pre- Adalimumab period, to 0,18 during Adalimumab therapy (p < 0,001 ). No patient developed related side effects during Adalimumab administration.
Thus far severe uveitis associated to Behçet Disease represent a serious sight- threatening condition whose prognosis depends on a prompt and adequate treatment. Our results demonstrate Adalimumab to be a very effective and safe option for treatment of patients with severe Behçet uveitis refractory to traditional immunuppressive and Infliximab therapy.
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