Abstract
Purpose :
To investigate the frequency of adverse events in non-infectious uveitis patients treated with 2 TNF inhibitors: adalimumab (ADA) and infliximab (IFX).
Methods :
Eighty non-infectious uveitis patients who presented to the uveitis clinic of The University of Tokyo Hospital and treated with TNF inhibitors during 2001 to 2018 were enrolled in this study; 27 non-infectious uveitis patients who treated with ADA (ADA group, 15 men and 12 women, mean follow-up periods of 25.6±25.7 months), and 53 Behcet’s disease patients who treated with IFX (IFX group, 40 men and 13 women, follow-up 72.6±47.1 months). The clinical records of the participants were retrospectively reviewed and the frequency of adverse events (AE) and serious adverse events (SAE) that could be associated with TNF inhibitors were analyzed.
Results :
Sixteen AE (0.28 events/person/year) occurred in 10 patients (37%) in ADA group, whereas only 1 SAE (0.017 events/person/year, onset of polymyalgia rheumatica) were observed. The most common AE in ADA group were infections (8 events), followed by skin eruptions (3 events), infusion reaction (3 event), hepatic impairment (1 event), and polymyalgia rheumatica (1 event). On the other hand, 27 AE (0.084 events/person/year) occurred in 20 patients (41%) in IFX group and 6 SAE (0.019 events/person/year) were complicated. The most common AE in IFX group were infections (11 events), followed by infusion reaction (7 events), skin eruptions (5 events), neoplasm (2 events), elevation of serum creatine phosphokinase (1 event) and rhabdomyolysis (1 event). Six SAE in IFX group were caused by 2 miliary tuberculosis, 2 neoplasm, 1 rhabdomyolysis and 1 sinusitis. Attenuation of TNF inhibitors due to SAE or AE occurred in 1 patient (elevation of serum β-D-glucan) in ADA group and 6 patients in IFX group (2 miliary tuberculosis, 2 skin eruption, 1 rhabdomyolysis and 1 infusion reaction).
Conclusions :
Our study showed that the frequency of AE in ADA group was higher compared to those in IFX group, whereas those of SAE was similar level. Further study with increased numbers of patients with longer follow-up periods must be necessary for confirming the difference of the frequency of AE and SAE between ADA and IFX therapy.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.