Comparative efficacy between adalimumab and infliximab in the treatment of non-infectious intermediate uveitis, posterior uveitis, and panuveitis: a retrospective observational study of 107 patients

Clin Rheumatol. 2019 Feb;38(2):407-415. doi: 10.1007/s10067-018-4228-6. Epub 2018 Aug 11.

Abstract

To compare the efficacy of adalimumab (ADA) and infliximab (IFX) in patients with non-infectious intermediate uveitis, posterior uveitis, and panuveitis. Demographic, clinical, instrumental, and therapeutic data from patients enrolled were collected at the start of treatment, at 12-month follow-up, and at the last follow-up assessment. One hundred seven patients (46 females, 187 eyes) were enrolled, 66 (61.7%) treated with ADA and 41 (38.3%) with IFX. Bilateral involvement was observed in 80 cases. The mean follow-up was 26.45 ± 21.71 months for ADA patients and 56.60 ± 56.04 months for IFX patients. The overall decrease of uveitis frequency during the first 12 months of treatment was 66.7% in the IFX group and 84.2% in the ADA group, compared to the previous 12 months (p = 0.09). A significantly higher corticosteroid dosage was found among patients treated with ADA at the last follow-up visit (p = 0.008). The percentage of patients co-administered with corticosteroids was significantly higher among ADA patients both at the 12-month visit (p = 0.03) and at the last visit (p = 0.0004). The frequency of uveitic macular edema (UME) was significantly higher among patients treated with ADA compared to those treated with IFX at the 12-month assessment (p = 0.015) and at the last follow-up visit (p = 0.011); central macular thickness was significantly higher in ADA group compared to the IFX group at the last follow-up assessment (p = 0.04). ADA and IFX have shown a similar efficacy in controlling uveitis relapses, but IFX showed a more pronounced corticosteroid sparing effect and a significantly higher capacity in resolving UME compared to ADA.

Keywords: Behçet’s disease; Macular edema; Retinal vasculitis; TNF-blocking antibodies; Uveitis.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adalimumab / therapeutic use*
  • Adult
  • Behcet Syndrome / drug therapy
  • Female
  • Humans
  • Infliximab / therapeutic use*
  • Male
  • Middle Aged
  • Retinal Vasculitis / drug therapy
  • Retrospective Studies
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Uveitis, Intermediate / drug therapy*
  • Uveitis, Posterior / drug therapy*

Substances

  • Tumor Necrosis Factor-alpha
  • Infliximab
  • Adalimumab