Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study
Objective. This study was aimed at assessing the long-term ocular control of adalimumab (ADA) in a large real-world population with noninfectious primary or secondary uveitis, focusing on the steroid-sparing effect and on disease-modifying antirheumatic drug (DMARD) cotreatment. Methods. In this ret...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2019/1623847 |
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| author | Alice Bitossi Alessandra Bettiol Elena Silvestri Gerardo Di Scala Daniela Bacherini Giuseppe Lopalco Vincenzo Venerito Florenzo Iannone Antonio Vitale Gian Marco Tosi Domenico Prisco Stanislao Rizzo Claudia Fabiani Luca Cantarini Gianni Virgili Lorenzo Vannozzi Giacomo Emmi |
| author_facet | Alice Bitossi Alessandra Bettiol Elena Silvestri Gerardo Di Scala Daniela Bacherini Giuseppe Lopalco Vincenzo Venerito Florenzo Iannone Antonio Vitale Gian Marco Tosi Domenico Prisco Stanislao Rizzo Claudia Fabiani Luca Cantarini Gianni Virgili Lorenzo Vannozzi Giacomo Emmi |
| author_sort | Alice Bitossi |
| collection | DOAJ |
| description | Objective. This study was aimed at assessing the long-term ocular control of adalimumab (ADA) in a large real-world population with noninfectious primary or secondary uveitis, focusing on the steroid-sparing effect and on disease-modifying antirheumatic drug (DMARD) cotreatment. Methods. In this retrospective, multicenter study, the efficacy of ADA was evaluated in terms of ocular control, changes in best-corrected visual acuity (BCVA), corticosteroid-sparing effect, and drug retention rate, overall and stratified according to DMARD cotreatment. Results. 106 patients were included. 88.7% had an associated systemic disease. After 6 and 12 months, proportions of patients with effective ocular control were 83.7% and 83.3%, respectively. At last the follow-up, 94.6% of patients had satisfactory ocular control. No difference in terms of ocular control at all time points emerged among patients starting ADA for ocular vs. systemic involvements. Patients with poor baseline BCVA remained stable or improved, while those with good BCVA hardly worsened. At 6 and 12 months, the median dose of prednisone significantly reduced to 5 mg/day (0-5) and 2.5 mg/day (0-5) (p<0.001). Over a median follow-up of 36 months, 38 subjects discontinued ADA treatment. Mild to moderate side effects were reported in 7 patients (6.6%). ADA ocular control, corticosteroid-sparing effect, and drug retention rate were not influenced by the concomitant use of DMARDs. Conclusion. The long-term ocular control of ADA in noninfectious primary or secondary uveitis is confirmed, also for BCVA preservation. Concomitant use of DMARDs does not provide additional benefits to ADA alone in terms of ocular control, steroid spare, and drug retention rate. |
| format | Article |
| id | doaj-art-10482ea7e0724a998e8c19d8f462e8c7 |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-10482ea7e0724a998e8c19d8f462e8c72025-08-20T03:55:44ZengWileyMediators of Inflammation0962-93511466-18612019-01-01201910.1155/2019/16238471623847Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective StudyAlice Bitossi0Alessandra Bettiol1Elena Silvestri2Gerardo Di Scala3Daniela Bacherini4Giuseppe Lopalco5Vincenzo Venerito6Florenzo Iannone7Antonio Vitale8Gian Marco Tosi9Domenico Prisco10Stanislao Rizzo11Claudia Fabiani12Luca Cantarini13Gianni Virgili14Lorenzo Vannozzi15Giacomo Emmi16Department of Surgery and Translational Medicine, Eye Clinic, University of Firenze, 50134, ItalyDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Firenze, 50139, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, 50134, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, 50134, ItalyDepartment of Surgery and Translational Medicine, Eye Clinic, University of Firenze, 50134, ItalyRheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, 70121, ItalyRheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, 70121, ItalyRheumatology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, 70121, ItalyResearch 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, 53100, ItalyOphthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, Siena 53100, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, 50134, ItalyDepartment of Surgery and Translational Medicine, Eye Clinic, University of Firenze, 50134, ItalyResearch 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, 53100, ItalyResearch 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, 53100, ItalyDepartment of Surgery and Translational Medicine, Eye Clinic, University of Firenze, 50134, ItalyDepartment of Surgery and Translational Medicine, Eye Clinic, University of Firenze, 50134, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, 50134, ItalyObjective. This study was aimed at assessing the long-term ocular control of adalimumab (ADA) in a large real-world population with noninfectious primary or secondary uveitis, focusing on the steroid-sparing effect and on disease-modifying antirheumatic drug (DMARD) cotreatment. Methods. In this retrospective, multicenter study, the efficacy of ADA was evaluated in terms of ocular control, changes in best-corrected visual acuity (BCVA), corticosteroid-sparing effect, and drug retention rate, overall and stratified according to DMARD cotreatment. Results. 106 patients were included. 88.7% had an associated systemic disease. After 6 and 12 months, proportions of patients with effective ocular control were 83.7% and 83.3%, respectively. At last the follow-up, 94.6% of patients had satisfactory ocular control. No difference in terms of ocular control at all time points emerged among patients starting ADA for ocular vs. systemic involvements. Patients with poor baseline BCVA remained stable or improved, while those with good BCVA hardly worsened. At 6 and 12 months, the median dose of prednisone significantly reduced to 5 mg/day (0-5) and 2.5 mg/day (0-5) (p<0.001). Over a median follow-up of 36 months, 38 subjects discontinued ADA treatment. Mild to moderate side effects were reported in 7 patients (6.6%). ADA ocular control, corticosteroid-sparing effect, and drug retention rate were not influenced by the concomitant use of DMARDs. Conclusion. The long-term ocular control of ADA in noninfectious primary or secondary uveitis is confirmed, also for BCVA preservation. Concomitant use of DMARDs does not provide additional benefits to ADA alone in terms of ocular control, steroid spare, and drug retention rate.http://dx.doi.org/10.1155/2019/1623847 |
| spellingShingle | Alice Bitossi Alessandra Bettiol Elena Silvestri Gerardo Di Scala Daniela Bacherini Giuseppe Lopalco Vincenzo Venerito Florenzo Iannone Antonio Vitale Gian Marco Tosi Domenico Prisco Stanislao Rizzo Claudia Fabiani Luca Cantarini Gianni Virgili Lorenzo Vannozzi Giacomo Emmi Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study Mediators of Inflammation |
| title | Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study |
| title_full | Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study |
| title_fullStr | Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study |
| title_full_unstemmed | Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study |
| title_short | Adalimumab Accounts for Long-Term Control of Noninfectious Uveitis Also in the Absence of Concomitant DMARD Treatment: A Multicenter Retrospective Study |
| title_sort | adalimumab accounts for long term control of noninfectious uveitis also in the absence of concomitant dmard treatment a multicenter retrospective study |
| url | http://dx.doi.org/10.1155/2019/1623847 |
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