LONG-TERM EXPERIENCE WITH ANTI-TNF α THERAPY IN THE TREATMENT OF REFRACTORY, NONINFECTIOUS INTERMEDIATE, POSTERIOR AND PANUVEITIS IN A TERTIARY REFERRAL CENTER: REVIEW OF OUTCOMES AND EFFICACY
Purpose
To study the efficacy and long-term effects of TNF-α inhibitors in patients with active non-infectious intermediate, posterior or panuveitis (NIPPU) refractory to conventional immunomodulatory treatment (IMT).
Methods
Review of medical charts of patients
Results
Included were 61 patients (104 eyes) of whom 34 were males (55.74%). Mean age at the time of diagnosis of uveitis was 26.5±16.14 years (range 4 to 67 years). Ocular inflammation was effectively controlled in 92 eyes (88.46%). The most commonly used TNF-α inhibitor was Adalimumab in 47 patients (77.05%). Mean follow-up time after baseline was 40 ±34.08 months (range 3-132 months). Before baseline, the average number of flares per eye was 1.5 ±1.1 flares/year and it decreased to 0.08 ±0.29 flares/year in the first year after baseline (p<0.0005). Mean logMAR visual acuity (VA) at baseline was 0.42 ±0.65 and remained stable at 24 months follow-up, with a mean logMAR VA of 0.40±0.73. The average prednisone dose at baseline was 25.5 ±20.8 mg/day and it decreased to 7.8 ±9.7mg/day at 6 months (p=0.03). The rate of treatment failure was 5.77% (4 patients, 6 eyes) and it was similar between adalimumab and infliximab.
Conclusion
TNF-α inhibitors resulted in optimal control of ocular disease in 93.44% of patients. Their use led to stabilization of visual acuity while allowing a significant steroid-sparing effect.
Conflict of interest
No
Authors 1
Last name
CORREDORES DIEB
Initials of first name(s)
J
Department
Ophthalmology - Hadassah Medical Center
City
JERUSALEM
Country
Israel
Authors 2
Last name
VOFO
Initials of first name(s)
B
Department
Ophthalmology - Hadassah Medical Center
City
JERUSALEM
Country
Israel
Authors 3
Last name
AMER
Initials of first name(s)
R
Department
Ophthalmology - Hadassah Medical Center
City
JERUSALEM
Country
Israel
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