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Raphael Lejoyeux, Christine Fardeau, david saadoun, sophie Tezenas Du Montcel, Eleonore Diwo, Bahram Bodaghi, Phuc Lehoang; INFLIXIMAB versus ADALIMUMAB for uveitis-related refractory macular edema. Invest. Ophthalmol. Vis. Sci. 2017;58(8):511.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) for the treatment of non infectious uveitis-related refractory macular edema (ME).
Patients diagnosed with non infectious uveitis related refractory ME and treated with IFX or ADA at Pitie Salpetriere hospital between 2006 and 2016 were included in this retrospective study. All patients were assessed including best corrected visual acuity (BCVA), clinical inflammatory parameters, multimodal imaging with fluorescein angiography, ICG and SD-OCT. Central foveal thickness (CFT) and retinochoroidal architecture were analysed with SD-OCT at baseline, 6 and 24 months after treatment initiation. Findings of patients treated with IFX were compared with those of patients treated with ADA.
Twelve patients with a mean age of 40 years and 13 patients with a mean age of 46 years were treated with ADA and IFX, respectively. At baseline, the mean BCVA of ADA patients was 0.59 logMar ((0; 1); median=0.54; SD=0.41) and the mean BCVA of IFX patients was 1.01 logMar ((0.30; 1.3) mediane=1; SD=0.30). The mean CFT of ADA patients was 417μ ((247; 732); median=350; SD=171) and the mean CFT of IFX patients was 450.4μ ((202; 617); median=521; SD=145).At 6 months (M6), the average decrease of CFT was more important in the IFX group in comparison to the ADA group (132.8 μ and 78μ). The average BCVA improved for both groups. The gain of BCVA was -0.10logMAR in the ADA group (SD=0.20) and -0.11logMAR in the IFX group (SD=0.21).A 24-month follow–up was possible for only 9 patients of the IFX group (3 discontinued IFX because of inefficacy, 1 had a follow-up less than 24 month and 5 patients of the ADA group (4 patients discontinued IFX because of inefficacy, 1 for a minor side effect, 2 were lost to follow-up). The average BCVA improved between M6 and M24 (from 0.48 to 0.33 log Mar) for the 5 eyes (ADA), but decreased for the 9 eyes (IFX) (from 0.89 to 0.99 log Mar). The average CFT decreased for the 5 eyes of the ADA group (from 339 μ at M6 to 321 μ at M24) and increased (from 317.6 μ at M6 to 342.5 μ at M24) for the 9 eyes of the IFX group.
Anti TNF alpha therapy seems to be an efficient treatment at 6 month for uveitis related refractory macular edema. No difference in efficacy was observed between IFX and ADA.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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