The efficacy of adalimumab in treating patients with central multifocal choroiditis
Purpose
To evaluate the efficacy of adalimumab (ADA) in patients with central multifocal choroiditis (cMFC) refractory to conventional corticosteroid-sparing immunomodulatory agents (IMT).
Methods
Medical records were reviewed from all patients with cMFC and treated with ADA with follow-up of at least 12 months. The study focused on the 12 months prior to and after the start of ADA. The imaging results were independently evaluated by two ophthalmologists. The main outcomes were the number of patients without a relapse of disease activity in 12 months after the start of ADA and the ability to stop the systemic corticosteroids.
Results
Twelve patients (18 eyes) were included. In 8/12 (67%) patients no relapse of disease activity was observed in the 12 months after the start of ADA. In 9/12 patients the systemic corticosteroid treatment could be stopped and in an additional 2 patients tapered to ≤7,5mg daily. In the 12 months before the start of ADA, the patients experienced a median of 2 (range 1-3) relapses of disease activity. Nine patients experienced relapses while treated with a combination of systemic corticosteroids (mean dose 13,6 mg range 5-25 mg) and IMT. Moreover, 3 patients treated with IMT, experienced relapses after tapering and stopping the systemic corticosteroids. In the 5 eyes with CNV before the start of ADA, the anti-VEGF injections could be stopped after the start of ADA.
Conclusion
ADA may be effective in patients with cMFC refractory to IMT and may be considered as a treatment option.
Conflict of interest
Yes
Details of conflicting interests
JH has received a grant from abbvie to conduct a research regarding the efficacy of adalimumab in children with noninfectious uveitis. The following authors have no financial disclosures: EL, J, L, NH.
Authors 1
Last name
DE GROOT
Initials of first name(s)
E.L.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 2
Last name
Ossewaarde-van Norel
Initials of first name(s)
J.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 3
Last name
Ho
Initials of first name(s)
L.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 4
Last name
ten Dam-van Loon
Initials of first name(s)
N.H.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 5
Last name
de Boer
Initials of first name(s)
J.H.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
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