Abstract
Purpose :
To characterize the clinical features and outcomes of patients with tubulointerstitial nephritis and uveitis (TINU) requiring treatment with biologic therapies.
Methods :
The Wisconsin Ocular Inflammatory Disease research registry was queried from inception (4/2021) to 11/2023 to identify patients with TINU requiring use of biologic therapy. Demographics, clinical characteristics, and treatment course were assessed.
Results :
Eight patients with TINU were identified. Median age at uveitis diagnosis was 13 years (9-50), 50% of patients were female. Uveitis subtypes included panuveitis (4 patients), anterior uveitis (3 patients) and anterior/intermediate uveitis (1 patient). Five patients were actively treated with adalimumab during the follow up interval and 1 had a prior history of adalimumab treatment; no other biologic therapies were used. Adalimumab treatment was more common in TINU patients with intermediate or panuveitis (5/6) than anterior uveitis (1/3). The anterior uveitis patient who required adalimumab had a clinical course complicated by bilateral optic disc edema unlike anterior uveitis patients treated without a biologic. Adalimumab therapy followed failure of mycophenolate mofetil (4 patients) or methotrexate (1 patient). Two patients required combination treatment with mycophenolate and adalimumab and one patient required weekly adalimumab dosing to obtain uveitis control; all patients on adalimumab treatment were able to fully wean systemic corticosteroids. Follow up is ongoing to determine recurrence of uveitis with ongoing adalimumab treatment and subsequent withdrawal.
Conclusions :
Adalimumab is efficacious as a steroid sparing therapeutic in TINU patients with posterior segment uveitis recalcitrant to antimetabolite treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.