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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

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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.

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Authors and Affiliations

  1. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy

    Claudia Fabiani & Gian Marco Tosi

  2. Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Policlinico “Le Scotte”, viale Bracci 1, 53100, Siena, Italy

    Antonio Vitale, Jurgen Sota, Ida Orlando, Stefano Gentileschi, Bruno Frediani, Mauro Galeazzi & Luca Cantarini

  3. Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S, Rome, Italy

    Donato Rigante

  4. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Giacomo Emmi

  5. Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy

    Alice Bitossi & Lorenzo Vannozzi

  6. Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari, Bari, Italy

    Giuseppe Lopalco & Florenzo Iannone

  7. Department of Ophthalmology and Otolaryngology, University of Bari, Bari, Italy

    Silvana Guerriero

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  1. Claudia Fabiani
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Correspondence to Claudia Fabiani or Luca Cantarini.

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The study has been approved by the Ethics Committee of Azienda Ospedaliera Universitaria Senese, Siena, Italy. The study protocol was conformed to the tenets of the Declaration of Helsinki and informed consent was obtained from all patients enrolled.

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Fabiani, C., Vitale, A., Rigante, D. et al. 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 38, 407–415 (2019). https://doi.org/10.1007/s10067-018-4228-6

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