Efficacy and Safety of Adalimumab in Patients with Behçet Uveitis: A Systematic Review and Meta-Analysis

ABSTRACT

Purpose

To examine the long-term efficacy and safety of adalimumab (ADA) in patients with Behçet uveitis (BU).

Methods

A systematic review and meta-analysis of observational studies was performed. Pooled results are presented as mean difference or standardized mean difference (std diff) and 95% confidence intervals (CI). Visual acuity (VA), intraocular inflammation grade, central macular thickness, corticosteroid (CS) sparing effect and adverse events were evaluated.

Results

Ten studies were included finally for quantitative and qualitative synthesis. ADA therapy resulted in 0.124 (95%CI: 0.084, 0.165) logMAR improvement in VA. In addition, ADA therapy resulted in decreased grade of intraocular inflammation [std diff, −1.187 (95%CI: -1.508, -0.866)] and macular thickness [std diff, −0.564 (95%CI: -0.843, -0.286)] and caused a decrease in CS dosage [std diff, −1.809 (95%CI: -2.420, -1.198)]. The pooled rate of overall adverse events for ADA in 301 patients was 8.5% (95%CI: 0.039, 0.177).

Conclusion

ADA is an efficient therapy that improves VA and controls intraocular inflammation, macular edema and retinal vasculitis. As the disease exposure time increased, improvement in VA was less. The safety and CS-sparing effect of ADA were demonstrated with few adverse effects. The results provided evidence that ADA can be used safely and efficiently as the first-line drug in patients with BU.

KEYWORDS:

• Adalimumab
• Behçet
• iridocyclitis
• TNF-α
• uveitis
• panuveitis

Acknowledgments

Ayse B. Gunay Sener thanks the “Republic of Turkey Higher Education Council” for the 100-2000 program scholarship for PhD. The authors would like to express their deepest gratitude to Prof. Dr. Osman Gunay for sharing his experience with us and guiding the writing of this article.

Author contributions

Concept and Design – H.S., C.E.; Data Collection and/or Processing – H.S., C.E.; Analysis and/or Interpretation –H.S., F.H., A.B.G.S.; Literature Search – C.E., H.S.; Writing Manuscript – C.E., H.S., A.B.G.S.; Critical Review – F.H.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09273948.2022.2157288

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.