Purpose: Tumor necrosis factor-alpha inhibitor, adalimumab (ADA), has been widely used in the treatment for non-infectious uveitis (NIU). The present study investigated the long-term clinical outcomes of adalimumab for non-infectious uveitis in the real world practice.
Methods: Records of 32 patients (women: 18, men: 14, 62 eyes) with NIU followed for at least 6 months after starting ADA , were retrospectively reviewed. The rate of treatment failure after starting ADA therapy was evaluated in both active NIU patients and inactive NIU patients using the criteria defined in VISUAL I and VISUAL II clinical triaIs
Results: The mean age was 50.2 years (14~79). One fourth had unclassified NIU and Vogt-Koyanagi-Harada disease (n=8) and sympathetic ophthalmia (n=4) were included. The most common type of uveitis was panuveitis (87%). The most common indication of ADA was failure to oral immunosuppressive drugs. The rate of active NIU at initiation of ADA was 43% (n=14). The median follow-up period after initiation of ADA was 24 months. The rate of treatment failure was 22% (n=7) at 6 months after initiation of ADA and 44% (n=14) over follow-up. The dose of oral corticosteroid and cyclosporine at 12 and 24 months was significantly reduced compared to that prior to ADA therapy. The ADA treatment was discontinued at 5 patients (16%) and no serious adverse events were observed over follow-up.
Conclusions: ADA showed the efficacy and safety for NIU and corticosteroid/cyclosporine sparing effect. The rate of treatment failure increased during long-term follow-up period.
