Raad Fátima, Luque Paula, García Ledo Sofía, Alda Lozano Alicia, Llorens Víctor, Espejo Antonio, Heras Henar, Santana Lucía, Trapiella Luis, Fanlo Patricia, Adán Alfredo, Espinosa Gerard, Navarrete Nuria
Department of Internal Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
Department of Internal Medicine, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Ocul Immunol Inflamm. 2025 Apr;33(3):340-346. doi: 10.1080/09273948.2024.2344712. Epub 2024 May 1.
To describe the efficacy and safety of adalimumab for the treatment of non-infectious uveitis (NIU) in four Uveitis Units from tertiary Spanish hospitals.
Multicenter and retrospective clinical cohort study including all patients with NIU treated with adalimumab from January 2012 to October 2022 in four uveitis units was performed. Efficacy was measured with the number of relapses, ocular inflammation and reduction in immunosuppression and corticosteroid dosage before and after adalimumab use. We collected data regarding adverse effects and examined the immunogenicity of adalimumab.
One hundred and twenty-two patients (59% females), with a mean age of 48.6 years (SD = 14.8) accounting for 217 eyes were included. The majority (92.6%) were Caucasian. Uveitis analyzed were predominantly panuveitis (34.7%), bilateral (77.9%), acute (41.5%), and non-granulomatous (90%). Most of them were immune mediated (42.6%), and the main reason to initiate adalimumab was refractory disease (96.7%). The analysis was statistically significant due to the reduction in the number of immunosuppressive drugs as well as the dose of oral corticosteroids and the number of relapses during follow-up ( < 0.001). The decrease in ocular inflammation parameters and the improvement in visual acuity ( < 0.05) were also significant. There were no deaths due to the drug and only one reported case of serious infection. In total, 10.9% of 73 patients tested developed anti-adalimumab antibodies and 4.1% lupus-like.
We consider adalimumab as a leading drug in the treatment of NIU with high safety and efficacy.
描述阿达木单抗在西班牙四家三级医院葡萄膜炎科室治疗非感染性葡萄膜炎（NIU）的疗效和安全性。
进行多中心回顾性临床队列研究，纳入2012年1月至2022年10月在四个葡萄膜炎科室接受阿达木单抗治疗的所有NIU患者。通过复发次数、眼部炎症以及使用阿达木单抗前后免疫抑制和皮质类固醇剂量的减少来衡量疗效。我们收集了有关不良反应的数据，并检测了阿达木单抗的免疫原性。
纳入122例患者（59%为女性），平均年龄48.6岁（标准差=14.8），共217只眼。大多数（92.6%）为白种人。分析的葡萄膜炎主要为全葡萄膜炎（34.7%）、双侧（77.9%）、急性（41.5%）和非肉芽肿性（90%）。大多数为免疫介导性（42.6%），启动阿达木单抗治疗的主要原因是难治性疾病（96.7%）。由于随访期间免疫抑制药物数量、口服皮质类固醇剂量以及复发次数减少，分析具有统计学意义（<0.001）。眼部炎症参数的降低和视力的改善也具有显著性（<0.05）。没有因该药物导致的死亡，仅报告1例严重感染病例。在73例接受检测的患者中，总共10.9%产生了抗阿达木单抗抗体，4.1%出现狼疮样反应。
我们认为阿达木单抗是治疗NIU的主要药物，具有高安全性和疗效。
