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Efficacy, retention rate and safety of adalimumab treatment in patients with non-infectious uveitis and scleritis: a real-world, retrospective, single-centre study

Eye volume 38, pages 893–901 (2024)Cite this article

Subjects

Abstract

Objectives

To evaluate the outcomes of adalimumab (ADA) treatment of patients with non-infectious uveitis and scleritis, focusing on efficacy, retention rate, and safety.

Methods

This retrospective, clinical cohort study included 62 patients (104 eyes) with active ocular inflammation treated with ADA. Primary outcomes were efficacy and cumulative drug retention rate (DRR) of ADA. The secondary outcomes included changes in ocular inflammatory parameters, changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT), corticosteroid-sparing effect, impact of concomitant use of disease-modifying antirheumatic drug (DMARD) and ADA as first or ≥2nd biotherapy line on DRR, and adverse events.

Results

Forty-five patients (72.6%) achieved inactive disease at the end of follow-up. DRR at 6, 12, 24, and 48 months was 96.8%, 89.2%, 63.1%, and 63.1%, respectively. Of the 18 patients whose bi-weekly ADA treatment was escalated to weekly ADA due to primary or secondary inefficacy, 10 patients had inactive disease finally. BCVA improved (p < 0.001) and CMT decreased (p < 0.001) significantly at 6, 12, and 24 months after ADA therapy compared to baseline. Percentage of patients treated with ≥10 mg/day corticosteroid (61.3% vs. 6.4%) and DMARDs combined with ADA (46.8% vs. 37.1%) were lower at 6 months than at baseline. Concomitant DMARDs (p = 0.579) and use of ADA as first or ≥2nd biotherapy line (p = 0.527) had no significant effect on DRR. Most common adverse event was tuberculosis-related infections.

Conclusions

ADA seems to be effective and safe with good DRR to control ocular inflammation. Escalation to weekly ADA treatment may be an effective option in patients with primary or secondary inefficacy.

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Fig. 1: Kaplan-Meier analysis of adalimumab retention probability.
Fig. 2: Changes in the mean best-corrected visual acuity (BCVA) and central macular thickness (CMT) of affected eyes during follow-up period.
Fig. 3: Drug retention rate of adalimumab (ADA).

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Data availability

The data supporting the study findings are available from the corresponding author upon request.

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Acknowledgements

We would like to thank Elif Bağatur Vurgun, Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey, for assisting with the data collection.

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Authors and Affiliations

  1. Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey

    Furkan Çam & Hande Celiker

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Contributions

FÇ: Study supervision. Concept and study design. Data collection, interpretation, analysis, and statistics. Drafting, revision, and final approval of the manuscript. HC: Study supervision. Concept and study design. Data interpretation. Revision and final approval of the manuscript.

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Correspondence to Hande Celiker.

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The study protocol was approved by the Institutional Review Board of Marmara University School of Medicine Hospital.

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The study was performed following the Declaration of Helsinki principles, and all patients provided written informed consent about having their medical information used in the study analysis.

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Çam, F., Celiker, H. Efficacy, retention rate and safety of adalimumab treatment in patients with non-infectious uveitis and scleritis: a real-world, retrospective, single-centre study. Eye 38, 893–901 (2024). https://doi.org/10.1038/s41433-023-02800-9

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