Adalimumab for treatment of severe Behçet's uveitis: a retrospective long-term follow-up study

CER7135
2014 Vol.32, N°4 ,Suppl.84
PI 0058, PF 0062
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PMID: 25005224 [PubMed]

Received: 25/11/2013
Accepted : 25/02/2014
In Press: 08/07/2014
Published: 30/09/2014

Abstract

OBJECTIVES:
Behçet`s disease (BD) is a chronic multisystem inflammatory disorder associated to uveitis that may represent a serious sight-threatening condition. The purpose of the present study is to assess the effectiveness of adalimumab as new strategic therapeutic approach in patients affected by severe Behçet`s uveitis.
METHODS:
Clinical data from twelve selected patients (22 eyes) were retrospectively analysed. All patients received 40 mg of adalimumab subcutaneously, once every 2 weeks, in addition to traditional immunosuppressive on-going therapy and eight of them were switched to adalimumab after failure of infliximab therapy. Primary outcome measures included ocular inflammatory activity, frequency of uveitis attacks and steroid-sparing effect. Secondary outcomes were changes of best-corrected visual acuity (BCVA), impact on traditional immunosuppressive therapy and occurrence of adalimumab-related side effects.
RESULTS:
Mean age of patients (11 males and 1 female) at the onset of disease was 24.34 years (±8.62 SD). Ocular involvement resulted bilateral in 83% of cases and mainly consisted in panuveitis (68% of eyes). After mean follow-up of 21 months (±9.63 SD) all patients but one (92%) achieved uveitis remission with BCVA improvement at least in one eye. Average uveitis attacks decreased from 2 to 0,42 during adalimumab (p<0.001) and daily-steroid dose was tapered in all adalimumab responders up to suspension in seven of them. No patient developed related side effects during adalimumab administration.
CONCLUSIONS:
Our results demonstrate that adalimumab is a very effective and safe option for treatment of patients with severe and resistant Behçet`s uveitis, providing an appropriate and long-term control of ocular inflammation.