Long-Term Follow-up of Patients With Uveitis Treated With Adalimumab: Response Rates and Reasons for Discontinuation of Therapy

Laura E.M. Eurelings, Tom O.A.R. Missotten, Mirjam E.J. van Velthoven, Paul L.A. van Daele, Jan A.M. van Laar, P. Martin van Hagen*, Alberta A.H.J. Thiadens, Saskia M. Rombach

*Corresponding author for this work

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Abstract

PURPOSE: To evaluate the effectiveness and reasons for discontinuation including the side effect profiles of adalimumab in a real-world setting. DESIGN: Retrospective clinical cohort study. METHODS: A medical chart review of clinical practice in 2 tertiary eye care services in Rotterdam, the Netherlands, was performed Data were collected from May 1, 2004, through September 1, 2020. Patients with noninfectious uveitis treated with adalimumab (n = 341; 633 affected eyes) were included. The primary outcome was the effectiveness of adalimumab, measured by the number of patients achieving inactive disease, remission, and relapse-free survival. The secondary outcomes were the reasons for discontinuation, including side effects, and the number of patients who developed antibodies. RESULTS: In total, 341 patients were treated with adalimumab between May 2004 and September 2020. The uveitis recurrence-free survival interval was 3.4 years (range, 0-13 years). Adalimumab had an acceptable side effect profile. A total of 178 patients achieved inactive disease while continuing adalimumab, and 51 patients maintained remission after discontinuing adalimumab. Reasons for discontinuation of adalimumab were no response, relapse, or reasons unrelated to the effectiveness of treatment. Adalimumab antibodies were present in 40 of 115 patients (35%). Antibodies were associated with lower adalimumab levels, and antibodies were observed more often in patients on adalimumab monotherapy (P < .01). CONCLUSIONS: Adalimumab is effective for patients with noninfectious uveitis, with an acceptable side effect profile. Although relapses can occur, the majority of the patients achieved inactive disease or remission after cessation of adalimumab, without other systemic immunosuppressive medication.

Original languageEnglish
Pages (from-to)194-204
Number of pages11
JournalAmerican Journal of Ophthalmology
Volume240
Early online date18 Mar 2022
DOIs
Publication statusPublished - 1 Aug 2022

Bibliographical note

Funding Information:
Funding/Support: Financial support was received from AbbVie, Lake Bluff, Illinois, USA, for this research. AbbVie had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. Financial Disclosures: P.M. van Hagen received consultancy fees from AbbVie in December 2019. All authors attest that they meet the current ICMJE criteria for authorship.

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© 2022 The Authors

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