Efficacy and Safety of Adalimumab for Treatment of Ocular Inflammatory Diseases

Abstract

Purpose:: The purpose of this study was to determine the efficacy and the safety of adalimumab in the treatment of ocular inflammatory diseases.

Methods:: A retrospective study of seven patients with ocular inflammation who were treated with adalimumab at our institution was done. Patients age ranged from 6 to 73 yrs (mean age: 33.3 ± 30 yrs). Patients had chronic recurrent uveitis or conjunctivitis secondary to rheumatoid arthritis (n=2), juvenile rheumatoid arthritis (n=2), Crohn’s disease and HLA-B27 (n=1), sarcoid (n=1), or ocular cicatricial pemphigoid (n=1). These patients had been previously treated with methotrexate, mycophenolate, infliximab, and/or cyclosporine; but uveitis was recurrent or persistent or patients did not tolerate the treatment. Patients received adalimumab injections at a dose of 40 mg every 1 (n=4) or 2 (n=3) week(s). Ocular inflammation and relapses as well as any side-effects were the main outcomes monitored.

Results:: Patients were followed over a period of 3 to 32 months (mean 13.9 ± 9.5 months) after initiation of adalimumab. Ocular inflammation resolved in seven out of seven patients after starting adalimumab. Six of seven patients have not had a relapse to date. One patient had a relapse when attempts were made to decrease the frequency of injections to every 5 weeks one year after starting therapy; however, inflammation subsided when frequency was increased to every 2 weeks. No side-effects were noted in any patients.

Conclusions:: Short term results of adalimumab treatment indicate that ocular inflammation can be controlled if adequate dosage is maintained. Adalimumab appears to be well tolerated and safe.

Keywords: uveitis-clinical/animal model • drug toxicity/drug effects