Pirani Vittorio, Pelliccioni Paolo, De Turris Serena, Rosati Alessandro, Franceschi Alessandro, Pasanisi Pierangelo, Gesuita Rosaria, Nicolai Michele, Mariotti Cesare
Eye Clinic, Polytechnic University of Marche, via Conca 61, 60126 Ancona, Italy.
Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, via Conca 61, 60126 Ancona, Italy.
J Clin Med. 2020 Feb 13;9(2):510. doi: 10.3390/jcm9020510.
: Non-infectious uveitis represents a leading cause of visual impairment, and inflammation control represents a major priority in tackling visual acuity loss due to complications such as macular edema; different immunomodulatory drugs are currently being used, including anti-TNF-alpha Adalimumab. : This was a monocentric observational study of 18 eyes of 18 patients with non-infectious uveitis treated with Adalimumab. The primary endpoint was the control of ocular inflammation. The secondary endpoints included the study of macular and choroidal thickness and architecture, visual acuity, changes in other treatments, and adverse effects. Results: Ocular inflammation was controlled at 12 months for 83.3% of patients. Central macular thickness improved from a median of 229.75 µm at baseline to 213 µm at 12 months, while choroidal thickness decreased by 11.54% at the end of the follow-up. A reduction of vasculitis on fluorescein angiography and of hyperreflective spots on optical coherence tomography was noted. Visual acuity also improved from 0.51 (logMAR) before treatment to 0.24 at more than 12 months ( = 0.01). A total of 11.1% of patients experienced side effects. : Our study confirms the efficacy of adalimumab for the control of ocular inflammation, visual acuity preservation, and for corticosteroid sparing.
非感染性葡萄膜炎是视力损害的主要原因,控制炎症是解决因黄斑水肿等并发症导致视力丧失问题的首要任务;目前正在使用不同的免疫调节药物,包括抗TNF-α阿达木单抗。
这是一项对18例接受阿达木单抗治疗的非感染性葡萄膜炎患者的18只眼睛进行的单中心观察性研究。主要终点是眼部炎症的控制。次要终点包括黄斑和脉络膜厚度及结构的研究、视力、其他治疗的变化以及不良反应。
83.3%的患者在12个月时眼部炎症得到控制。中心黄斑厚度从基线时的中位数229.75µm改善至12个月时的213µm,而脉络膜厚度在随访结束时下降了11.54%。荧光素血管造影显示血管炎减轻,光学相干断层扫描显示高反射斑点减少。视力也从治疗前的0.51(logMAR)提高到超过12个月时的0.24(P = 0.01)。共有11.1%的患者出现副作用。
我们的研究证实了阿达木单抗在控制眼部炎症、保护视力和节省皮质类固醇方面的疗效。