Infliximab and Adalimumab for Uveitis

Abstract

Purpose: To describe the corticosteroid-sparing success in controlling chronic uveitis in patients treated with TNFα inhibitors.

Methods: Retrospective longitudinal case series of patients started on infliximab (n = 31) or adalimumab (n = 12) for chronic noninfectious uveitis at a tertiary referral center. The main outcome was corticosteroid-sparing success. Secondary outcomes were sustained control of inflammation regardless of corticosteroid-sparing effect, tapering of concurrent nonbiologic therapy, and discontinuation.

Results: Sustained control of inflammation with corticosteroid-sparing success on infliximab and adalimumab, respectively, was achieved in 33.3 and 37.5% at 3 months, 60.7 and 62.5% at 6 months, and 60.9 and 57.1% at 12 months. Median time to this outcome was 98 days for infliximab and 169 days for adalimumab. Six infliximab patients had adverse reactions.

Conclusions: Infliximab and adalimumab improve control of ocular inflammation and are successful corticosteroid-sparing agents. However, time to corticosteroid-sparing control of inflammation may take a few months with either agent, and adverse reactions may limit treatment.

Keywords::

• adalimumab
• corticosteroid-sparing
• corticosteroids
• infliximab
• TNF-alpha inhibitors
• uveitis

ACKNOWLEDGMENT

This research was supported by a National Eye Institute K23EY017897 grant and a Research to Prevent Blindness Career Development Award to Dr. Acharya. This work was also supported by departmental grants NEI EY06190 and an unrestricted grant from the Research to Prevent Blindness Foundation. The sponsors had no role in the design or conduct of the study, data analysis, or manuscript preparation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.