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TNF inhibitor may treat refractory uveitis
A novel therapy proved effective in treating refractory uveitis in patients who responded poorly to standard therapies, according to a study.
The study authors evaluated Humira (adalimumab, Abbott), a TNF inhibitor used to treat several systemic diseases.
“Adalimumab seems to be well tolerated and helpful in decreasing inflammatory activity in refractory uveitis and may reduce steroid requirement. Further controlled studies of adalimumab for uveitis are warranted,” the study authors said.
The prospective study included 131 patients with refractory uveitis who failed to respond to prednisone and at least one other systemic immunosuppressant. Mean patient age was 27.3 years.
Twenty-seven patients had idiopathic uveitis; 82% of patients had inflammation in the anterior chamber, and 59% had inflammation in the vitreous cavity.
Patients were administered a subcutaneous injection of 40 mg of adalimumab every other week for 6 months. Immunosuppressants were tapered at 6 weeks, after three adalimumab injections.
Anterior chamber inflammation decreased from 1.51 at baseline to 0.25 at 6 months. Vitreous inflammation decreased from 1.03 to 0.14. Both decreases were statistically significant (P < .001). Macular thickness decreased from 296 µm at baseline to 240 µm at 6 months (P < 0.001).
Visual acuity improved by 15 or more letters in 32 of 150 eyes (21.3%), remained the same in 113 eyes (75.4%) and decreased by 15 or more letters in five eyes (3.3%).
Corticosteroid dosing decreased from 0.74 mg/kg/day to 0.20 mg/kg/day; the decrease was statistically significant (P < .001).
Cystoid macular edema resolved completely in 28 of 40 eyes at 6 months, the authors said.