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  • Adalimumab is safe and effective for noninfectious uveitis

    Uveitis

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    Review of: Long-term safety and efficacy of adalimumab in patients with noninfectious intermediate uveitis, posterior uveitis, or panuveitis

    Suhler E, Jaffee G, Fortin E, et al. Ophthalmology, June 2021

    In this phase 3 study, investigators report the long-term efficacy and safety of extended adalimumab treatment for patients with noninfectious intermediate uveitis, posterior uveitis or panuveitis.

    Study design

    VISUAL III is an open-label, multicenter extension study that included 364 patients from VISUAL I or II who did not experience treatment failure (inactive uveitis) or who discontinued the study after treatment failure (active uveitis). Patients received 40 mg of subcutaneous adalimumab every other week.

    Outcomes

    By week 150, 85% of patients achieved quiescence, with 54% of patients with active uveitis and 89% of patients with inactive uveitis becoming steroid free. Average corticosteroid use was reduced from 9.4 mg/day to 1.5 mg/day. The most common long-term adverse event was infections (79 events/100 patient-years), and the rate of active and latent tuberculosis was 1.8 events/100 patient-years. Other adverse events included malignancy and demyelinating disorders.

    Limitations

    After 78 weeks, there was a decrease in the number of patients with reported data due to study sites closing. The study lacked a comparative control group and included patients who were simultaneously receiving other immunosuppressive agents and local corticosteroids.

    Clinical significance

    Adalimumab leads to disease control and maintenance in patients with active and inactive disease. The safety profile in this study is similar to what has been reported previously (VISUAL I and II).