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

circle PURPOSE: To evaluate the effectiveness and reasons for discontinuation including the side effect profiles of adal-imumab in a real-world setting. circle DESIGN: Retrospective clinical cohort study. circle 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 nonin-fectious uveitis treated with adalimumab (n = 341; 633 affected eyes) were included. The primary outcome was the effectiveness of adalimumab, measured by the num-ber 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. circle RESULTS: In total, 341 patients were treated with adal-imumab 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). circle CONCLUSIONS: Adalimumab is effective for pa-tients with noninfectious uveitis, with an accept-able side effect profile. Although relapses can occur, the majority of the patients achieved inactive disease or remission after cessation of adali-mumab, without other systemic immunosuppressive medication. (Am J Ophthalmol 2022;240: 194-204. (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/

Automated summary

This retrospective clinical cohort study evaluated the effectiveness of adalimumab in treating noninfectious uveitis, with an acceptable side effect profile. Most patients achieved inactive disease or remission after discontinuation of adalimumab.