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Adalimumab in patients with vision-threatening uveitis: real-world clinical experience

OBJECTIVES: Biologics are rapidly emerging as an effective vision saving addition to systemic uveitis therapy. The aim of this multicentre retrospective study is to review the outcomes of a large group of patients treated with adalimumab. METHODS: A retrospective chart review of patients with refrac...

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Autores principales: Tang Lee Say, Timothy Lee, Yang, Verlyn, Fingret, Jacob M, Zagora, Sophia, Symes, Richard, Younan, Christine, Cornish, Elisa Eleanor, Verma, Nitin, Sammel, Anthony, Wakefield, Denis, Speden, Deborah, McCluskey, Peter J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477319/
https://www.ncbi.nlm.nih.gov/pubmed/34632076
http://dx.doi.org/10.1136/bmjophth-2021-000819
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author Tang Lee Say, Timothy Lee
Yang, Verlyn
Fingret, Jacob M
Zagora, Sophia
Symes, Richard
Younan, Christine
Cornish, Elisa Eleanor
Verma, Nitin
Sammel, Anthony
Wakefield, Denis
Speden, Deborah
McCluskey, Peter J
author_facet Tang Lee Say, Timothy Lee
Yang, Verlyn
Fingret, Jacob M
Zagora, Sophia
Symes, Richard
Younan, Christine
Cornish, Elisa Eleanor
Verma, Nitin
Sammel, Anthony
Wakefield, Denis
Speden, Deborah
McCluskey, Peter J
author_sort Tang Lee Say, Timothy Lee
collection PubMed
description OBJECTIVES: Biologics are rapidly emerging as an effective vision saving addition to systemic uveitis therapy. The aim of this multicentre retrospective study is to review the outcomes of a large group of patients treated with adalimumab. METHODS: A retrospective chart review of patients with refractory non-infectious, active uveitis treated with adalimumab was conducted. The main outcome measures were ability to reduce prednisolone dose, ability to control uveitis, final visual acuity and time to treatment failure. RESULTS: Forty-six patients with uveitis, treated with adalimumab were included in the study. The most common anatomical uveitis phenotype was panuveitis (n=17, 37.0%). The most common diagnosis was idiopathic uveitis (n=19, 41.3%). At their latest review (mean: 4.46 years; median 4.40 years), 35 (76.1%) patients were able to discontinue corticosteroids, 11 (23.9%) patients were able to taper to <7.5 mg/day and only 1 (2.2%) patient required 10 mg of prednisone. The mean visual acuity at the latest follow-up of the worse eye was logarithm of the minimum angle of resolution (logMAR) 0.42 (SD 0.72), while the mean visual acuity of the better eye was logMAR 0.19 (SD 0.34). Of the 89 eyes, 21 (23.6%) eyes improved by at least 2 lines, 5 eyes (5.6%) deteriorated by ≥2 lines while vision was unchanged in the remaining 63 (70.8%) eyes. The time to recurrence was 1 in 12.47 person-years for adalimumab, with a 17.4% (8 patient) relapse rate. There were no serious adverse events. CONCLUSIONS: This study highlights the efficacy of adalimumab in patients with vision-threatening non-infectious uveitis, preserving vision and allowing reduction of corticosteroid dose.
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spelling pubmed-84773192021-10-08 Adalimumab in patients with vision-threatening uveitis: real-world clinical experience Tang Lee Say, Timothy Lee Yang, Verlyn Fingret, Jacob M Zagora, Sophia Symes, Richard Younan, Christine Cornish, Elisa Eleanor Verma, Nitin Sammel, Anthony Wakefield, Denis Speden, Deborah McCluskey, Peter J BMJ Open Ophthalmol Uveitis OBJECTIVES: Biologics are rapidly emerging as an effective vision saving addition to systemic uveitis therapy. The aim of this multicentre retrospective study is to review the outcomes of a large group of patients treated with adalimumab. METHODS: A retrospective chart review of patients with refractory non-infectious, active uveitis treated with adalimumab was conducted. The main outcome measures were ability to reduce prednisolone dose, ability to control uveitis, final visual acuity and time to treatment failure. RESULTS: Forty-six patients with uveitis, treated with adalimumab were included in the study. The most common anatomical uveitis phenotype was panuveitis (n=17, 37.0%). The most common diagnosis was idiopathic uveitis (n=19, 41.3%). At their latest review (mean: 4.46 years; median 4.40 years), 35 (76.1%) patients were able to discontinue corticosteroids, 11 (23.9%) patients were able to taper to <7.5 mg/day and only 1 (2.2%) patient required 10 mg of prednisone. The mean visual acuity at the latest follow-up of the worse eye was logarithm of the minimum angle of resolution (logMAR) 0.42 (SD 0.72), while the mean visual acuity of the better eye was logMAR 0.19 (SD 0.34). Of the 89 eyes, 21 (23.6%) eyes improved by at least 2 lines, 5 eyes (5.6%) deteriorated by ≥2 lines while vision was unchanged in the remaining 63 (70.8%) eyes. The time to recurrence was 1 in 12.47 person-years for adalimumab, with a 17.4% (8 patient) relapse rate. There were no serious adverse events. CONCLUSIONS: This study highlights the efficacy of adalimumab in patients with vision-threatening non-infectious uveitis, preserving vision and allowing reduction of corticosteroid dose. BMJ Publishing Group 2021-09-27 /pmc/articles/PMC8477319/ /pubmed/34632076 http://dx.doi.org/10.1136/bmjophth-2021-000819 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Uveitis
Tang Lee Say, Timothy Lee
Yang, Verlyn
Fingret, Jacob M
Zagora, Sophia
Symes, Richard
Younan, Christine
Cornish, Elisa Eleanor
Verma, Nitin
Sammel, Anthony
Wakefield, Denis
Speden, Deborah
McCluskey, Peter J
Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title_full Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title_fullStr Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title_full_unstemmed Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title_short Adalimumab in patients with vision-threatening uveitis: real-world clinical experience
title_sort adalimumab in patients with vision-threatening uveitis: real-world clinical experience
topic Uveitis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477319/
https://www.ncbi.nlm.nih.gov/pubmed/34632076
http://dx.doi.org/10.1136/bmjophth-2021-000819
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