Adalimumab Treatment for Recurrence of Ocular Inflammation in Patients with Vogt-Koyanagi-Harada Disease: a multicenter study

Abstract

Purpose : We investigated efficacy and safety of adalimumab (ADA) treatment for exacerbation or recurrence of Vogt-Koyanagi-Harada (VKH) patients.

Methods : This is a retrospective, multi-centre cohort study. Medical records of 70 VKH patients who received ADA treatment for more than 6 months were retrospectively investigated for best corrected visual acuity (BCVA), aqueous flare counts, subfoveal choroidal thickness (SFCT), indocyanine green angiography (ICGA) score, corticosteroid doses, and presence or absence of immunosuppressors at baseline before the initiation of ADA and 6 months later. Adverse events were recorded.

Results : The mean age of VKH patients was 54.8 ± 15.1 years and male/female ratio was 34/36. SFCT, ICGA scores, and corticosteroids and cyclosporine doses were significantly reduced by ADA treatment for 6 months compared to baseline, while LogMAR visual acuity and flare counts were also improved without being statistically significant. When sub-classified into VKH patients with the presence of sunset glow fundus (SGF) and without SGF, SFCT, ICGA scores, and mean corticosteroid doses were significantly lower after ADA treatment for 6 months, but the difference was not significant for LogMAR visual acuity and flare counts compared to baseline in the group without SGF. In the group with SGF, LogMAR visual acuity, ICGA scores and mean corticosteroid doses were significantly lower, but the difference was not significant for flare counts and SFCT when compared to baseline. Adverse events were observed in 17.1%, in which infection including tuberculosis was at 7.14% and psoriasis was at 2.86%. ADA treatment was continued in 91.4%.

Conclusions : ADA was shown to be effective to achieve remission of VKH disease refractory to conventional immunosuppressive treatments, and was generally well tolerated with few serious adverse events.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.