This abstract is assigned to sessions
| Title | Evaluation of the use of adalimumab in the treatment of VKH disease and sympathetic ophthalmia |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To evaluate outcomes in patients with either Vogt-Koyanagi-Harada (VKH) disease or sympathetic ophthalmia (SO) who received adalimumab (ADA) during their treatment course. |
| Methods | Clinical records of 5 patients were reviewed retrospectively. The mean age was 67.6 years at initiation of ADA, and the median follow-up on ADA was 13 months. |
| Results | Initial treatment consisted of high-dose systemic corticosteroids in 4 patients, followed by transition to cyclosporine (Cy) for steroid-sparing. In the remaining 1 patient with VKH disease, initial treatment consisted of bilateral sub-Tenon’s corticosteroid injections with immediate initiation of Cy. Transition to ADA therapy was initiated for Cy-induced renal dysfunction in all 5 patients, and posterior inflammatory recurrences in 1 patient. One patient developed injection site inflammation at 3 weeks on ADA, necessitating ADA discontinuation. Of the remaining patients, Cy was tapered in all 4 patients, and was completely discontinued in 3 patients by 6 months. No recurrences were observed in 3 patients, however 1 patient with continued to have posterior inflammatory recurrences despite ADA and Cy. Seven of 8 eyes had a best-corrected visual acuity of > 0.8 at initiation of ADA treatment, and this remained unchanged over follow-up. |
| Conclusion | The use of ADA was effective in allowing reduction or discontinuation of Cy in 4 of 5 patients with VHK disease or SO. We conclude that ADA is a useful addition to our immunomodulatory armamentarium for these diseases. |
| Conflict of interest | Yes |
| Details of conflicting interests | Annabelle A. Okada: consultant to AbbVie Japan, Astellas Pharma Japan, Bayer AG, Daiichi Sankyo; lecture fees from Alcon Pharm Japan, Mitsubishi Tanabe Pharma, Novartis Pharma Japan, Santen Pharmaceutical Corporation, Senju Pharmaceutical Corporation; grant support from Alcon Pharma Japan, Bayer Yakuhin, Mitsubishi Tanabe Pharma.
Hiroshi Keino: lecture fees from Santen Pharma Corporation, Alcon Pharma Japan,
Nikon Healthcare Japan, Senju Pharmaceutical Corporation;
grant and lecture fees from Mitsubishi Tanabe Pharma. |
Author 1
| Last name | NAKAYAMA |
| Initials of first name(s) | M |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 2
| Last name | ABE |
| Initials of first name(s) | S |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 3
| Last name | HAYASHI |
| Initials of first name(s) | I |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 4
| Last name | KEINO |
| Initials of first name(s) | H |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 5
| Last name | WATANABE |
| Initials of first name(s) | T |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 6
| Last name | ANDO |
| Initials of first name(s) | Y |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
Author 7
| Last name | OKADA |
| Initials of first name(s) | A |
| Department | Ophthalmology |
| City | Tokyo |
| Country | Japan |
