Outcomes in non-infectious uveitis patients treated with adalimumab in a tertiary eye care center

To evaluate the efficacy of adalimumab (ADA) treatment in non-infectious uveitis and the effect of disease duration, age, and etiology on treatment outcome.

This retrospective study included patients with active non-infectious uveitis who were on ADA treatment with at least 3 months follow-up from a single tertiary care center. Uveitis type, any associated systemic disease, uveitis duration before ADA, duration of ADA treatment, best-corrected visual acuity (BCVA), anterior chamber cell (ACC) grade, vitritis grade, intraocular pressure (IOP) values, central macular thickness (CMT), fundus fluorescein angiography (FFA) score, complications and relapse rate were recorded.

A total of 146 eyes of 77 patients (women=41, men=36) were included in the analysis. The mean age was 25.1±15.7 years. BCVA showed no significant improvement overall (+0.08, P=0.059) following ADA treatment. A weak negative correlation was found between the change in BCVA from baseline to final follow-up and disease duration before initiating ADA (r=-0.22, P=0.005). ACC and vitritis grade decreased significantly (-0.50, p<0.001; -0.51, P<0.001; respectively). The decrease in CMT was not significant (-18.6, P=0.390). Twenty patients (25.9%) experienced a relapse during treatment, and the mean relapse time was 24.9 months (95%CI: 21.0-28.9). Eleven (14.1%) of the patients required systemic corticosteroids as bridge therapy before ADA treatment and to suppress relapse while on ADA treatment. The mean dose of methylprednisolone decreased from 55.2±20.3mg to 12.3±18.0mg, and corticosteroids were discontinued in 7 of these patients.

ADA effectively controls intraocular inflammation and maintains visual stability in patients with non-infectious uveitis. Although BCVA did not show a statistically significant improvement overall, initiating ADA treatment early was correlated with better visual outcomes in some patients, particularly those who began treatment shortly after their disease onset. The corticosteroid burden was reduced.