Abstract
Purpose :
To investigate the efficacy of weekly adalimumab (ADA) in patients with non-infectious ocular inflammation who failed ADA every two weeks.
Methods :
A single-center, retrospective analysis of patients with refractory ocular inflammation on ADA every 2 weeks who were switched to weekly dosing, seen from January 2012 to April 2019. The main outcome measure was disease control versus treatment failure within 6 months of weekly therapy. Treatment failure was defined by: persistent anterior chamber cell, new or persistent angiographic inflammation, new or persistent tomographic intraretinal or subretinal fluid, active retinal/choroidal lesions, orbital pain, and scleral injection.
Results :
Twenty-five patients (18 females, 7 males, median age 14 years, range 2-68 years) were evaluated. The types of uveitis include juvenile idiopathic arthritis (n =6), idiopathic chronic anterior/intermediate uveitis (n=3), scleritis (n=4), sarcoidosis (n= 2), tubulointerstitial nephritis panuveitis (n=1), Vogt Koyanagi Harada syndrome (n=1), birdshot chorioretinopathy (n=2), and HLA-B27 associated chronic anterior uveitis (n=2). Fourteen patients (56%) achieved disease control on weekly therapy with 6 months of follow up. In the treatment success cohort, six were receiving concomitant antimetabolite therapy, five were able to stop topical corticosteroids, and 3 were able to reduce topical corticosteroids. Weekly dosing appeared more likely to succeed in cases of juvenile idiopathic arthritis (5 out of 6).
Conclusions :
In this series of patients with refractory ocular inflammation, increasing the dose of ADA from every two weeks to once a week conferred a beneficial reduction in ocular inflammation and improved disease control in more than half the patients.
This is a 2020 ARVO Annual Meeting abstract.