Khayyam Durrani1,2, John H Kempen3,4, Gui-Shuang Ying3, R Oktay Kacmaz1, Pichaporn Artornsombudh1,3, James T Rosenbaum5,6, Eric B Suhler5,6,7, Jennifer E Thorne8,9, Douglas A Jabs9,10,11, Grace A Levy-Clarke12, Robert B Nussenblatt12, C Stephen Foster1,2. 1. a Massachusetts Eye Research & Surgery Institution and Ocular Immunology and Uveitis Foundation , Waltham , Massachusetts , USA. 2. b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA. 3. c Center for Preventive Ophthalmology and Biostatistics. 4. d Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics & Epidemiology , Perelman School of Medicine, University of Pennsylvania , Philadelphia , Pennsylvania , USA. 5. e Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA. 6. f Department of Medicine , Oregon Health and Science University , Portland , Oregon , USA. 7. g Portland Veteran's Affairs Medical Center , Portland , Oregon , USA. 8. h Department of Ophthalmology , Johns Hopkins University School of Medicine , Baltimore , Maryland , USA. 9. i Johns Hopkins University Bloomberg School of Public Health , Baltimore , Maryland , USA. 10. j Department of Ophthalmology , Icahn School of Medicine at Mount Sinai , New York , New York , USA. 11. k Department of Medicine , Icahn School of Medicine at Mount Sinai , New York , New York , USA. 12. l Laboratory of Immunology, National Eye Institute , Bethesda , Maryland , USA.
Abstract
PURPOSE: To evaluate adalimumab as an immunomodulatory treatment for non-infectious ocular inflammatory diseases. METHODS: Characteristics of patients treated with adalimumab were abstracted in a standardized chart review. Main outcomes measured were control of inflammation, corticosteroid-sparing effect, and visual acuity. RESULTS: In total, 32 patients with ocular inflammation were treated with adalimumab. The most common ophthalmic diagnoses were anterior uveitis, occurring in 15 patients (47%), and scleritis, occurring in 9 patients (28%). At 6 months of therapy, among 15 eyes with active inflammation, 7 (47%) became completely inactive, and oral prednisone was reduced to ≤10 mg/day in 2 of 4 patients (50%). On average, visual acuity decreased by 0.13 lines during the first 6 months of treatment. Adalimumab was discontinued because of lack of effectiveness in four patients within 6 months. CONCLUSIONS: Adalimumab was moderately effective in controlling inflammation in a group of highly pre-treated cases of ocular inflammatory disease.
PURPOSE: To evaluate adalimumab as an immunomodulatory treatment for non-infectious ocular inflammatory diseases. METHODS: Characteristics of patients treated with adalimumab were abstracted in a standardized chart review. Main outcomes measured were control of inflammation, corticosteroid-sparing effect, and visual acuity. RESULTS: In total, 32 patients with ocular inflammation were treated with adalimumab. The most common ophthalmic diagnoses were anterior uveitis, occurring in 15 patients (47%), and scleritis, occurring in 9 patients (28%). At 6 months of therapy, among 15 eyes with active inflammation, 7 (47%) became completely inactive, and oral prednisone was reduced to ≤10 mg/day in 2 of 4 patients (50%). On average, visual acuity decreased by 0.13 lines during the first 6 months of treatment. Adalimumab was discontinued because of lack of effectiveness in four patients within 6 months. CONCLUSIONS:Adalimumab was moderately effective in controlling inflammation in a group of highly pre-treated cases of ocular inflammatory disease.
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