Experience of using adalimumab in treating sight-threatening paediatric or adolescent Behcet's disease-related uveitis

J Ophthalmic Inflamm Infect. 2019 Jul 31;9(1):14. doi: 10.1186/s12348-019-0181-z.

Abstract

Purpose: To report the clinical outcomes of adalimumab in treating refractory Behcet's disease (BD)-related uveitis in paediatric or adolescent patients.

Methods: Retrospective review of five paediatric or adolescent patients with BD-related uveitis with a minimum follow-up of 24 months.

Results: Disease quiescence was observed in 9 (90%) of 10 eyes at 12 months. The mean number of relapses per year per patient was 5 (range, 3-7) before initiation of adalimumab treatment. This was reduced to 0.2 relapse per patient per year among the five patients during the first 24 months after starting adalimumab treatment. At baseline, 5 eyes had active retinal vasculitis. Retinal vasculitis resolved in all cases (100%) after starting adalimumab. The mean time to complete resolution of inflammation was 3.4 weeks. The mean ± standard deviation logMAR best-corrected visual acuity was 0.711 ± 0.63 at baseline and improved to 0.172 ± 1.04 at 12 months (P < 0.001). None of the patients developed any adverse events associated with adalimumab treatment.

Conclusion: Adalimumab was effective in preventing irreversible sight-threatening BD-related uveitis in paediatric or adolescent patients. Adalimumab appears to be a promising treatment option for young patients with recalcitrant BD-related uveitis and has a favourable safety profile.

Keywords: Adalimumab; Behcet’s disease; Intraocular inflammation; Retinal vasculitis; Uveitis.