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Yosuke Harada, Yoshiaki Kiuchi; Adalimumab for the treatment of uveitis in a Japanese population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):405.
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Adalimumab is approved for the treatment of patients with non-infectious uveitis in Japan. We performed a retrospective review of patient data to evaluate the efficacy of adalimumab for non-infectious uveitis in a Japanese population.
The medical records of patients with non-infectious uveitis treated with adalimumab at Hiroshima University Hospital from September 2016 to June 2017 were reviewed. Demographic and clinical characteristics, including type of uveitis, inflammation control after starting adalimumab, and corticosteroid-sparing effects were obtained. The reason for starting adalimumab therapy and any reported side effects were also reviewed.
Eleven patients (8 males) were included of mean age 35.5±14.0 years (range 17–57 years). The most common diagnosis was retinal vasculitis (45.4%), followed by anterior uveitis (27.2%), Behcet’s disease (18.1%), and periphlebitis (9.1%). All patients had multiple episodes of recurrence of inflammation with reduced dosing or discontinuation of topical or oral steroids. Two patients (18.1%) developed glaucoma during steroid therapy. Six patients (54.5%) had been treated with immunomodulatory therapy such as methotrexate or cyclosporine. Two (18.1%) temporarily discontinued adalimumab therapy because of folliculitis or psoriasiform skin lesions as a probable paradoxical reaction to adalimumab, respectively. In all patients (n=5) followed for more than 5 months after starting adalimumab, a corticosteroid-sparing effect was observed, with a decrease in the mean dose of prednisolone from 13.9±12.4 to 1.3±1.9 mg/day. A trend in improvement in both anterior cell and vitreous haze was observed over 5 months, graded in accordance with the Standardization of Uveitis Nomenclature (SUN) Working Group Criteria (from 1.67 to 0.28, and from 1.50 to 0.11, respectively). Deterioration in inflammation after starting therapy was not observed in any patient.
Adalimumab is a useful agent for the treatment of non-infectious uveitis. Although it is approved in Japan for panuveitis and intermediate and posterior uveitis, we also showed its effectiveness in anterior uveitis. This treatment may be suitable for uveitis patients with resistance to steroid or conventional immunomodulatory therapy with methotrexate or cyclosporine, for example.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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