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TitleLONG-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
PurposeTo 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).
MethodsReview of medical charts of patients

ResultsIncluded 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.
ConclusionTNF-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 interestNo
Authors 1
Last nameCORREDORES DIEB
Initials of first name(s)J
DepartmentOphthalmology - Hadassah Medical Center
CityJERUSALEM
CountryIsrael
Authors 2
Last nameVOFO
Initials of first name(s)B
DepartmentOphthalmology - Hadassah Medical Center
CityJERUSALEM
CountryIsrael
Authors 3
Last nameAMER
Initials of first name(s)R
DepartmentOphthalmology - Hadassah Medical Center
CityJERUSALEM
CountryIsrael