2009•Acta OphthalmologicaRequires access

Adalimumab (Humira®) therapy for uveitis

Piergiorgio Neri

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Abstract

Abstract Purpose To review the current Literature and to describe the experience of a tertiary referral centre on Adalimumab (Humira®) therapy for uveitis. Methods The current literature is reviewed and the experience of a tertiary referral centre is reported. Results Chronic non‐infectious uveitis (NU) remains one of the most challenging problems in ophthalmology. Often, early and aggressive treatment is needed for a good visual acuity outcome. Local and oral corticosteroids remain the first line of treatment, even though side effects, such as glaucoma, cataract and Cushing Syndrome, can be serious and not tolerable. Therefore, a variety of immunosuppressive agents are in use, such as Cyclophosphamide, Methotrexate, Cyclosporin A, Azathioprine and Mycophenolate mofetil. Recently, new types of drugs, called “biologic agents”, are available. In the model of experimental autoimmuneuveitis (EAU) it has been demonstrated that tumor necrosis factor‐alpha (TNF‐α) may play a key role in uveitis. Beside other anti‐ TNF‐α drugs, Adalimumab (Humira®) is the newest biologic drug available. Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF‐α that blocks the TNF‐α biologic activity. Adalimumab seems to control uveitis unresponsive to the traditional immunosuppressive agents and, moreover, its subcutaneous administration makes the procedure easier. Conclusion The data in the literature suggest that Adalimumab can be an effective and safe therapy for the uveitis, by controlling inflammation of the eye. The duration of treatment have still to be investigated in larger studies and further trials are mandatory to validate the preliminary data.

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Abstract Purpose To review the current Literature and to describe the experience of a tertiary referral centre on Adalimumab (Humira®) therapy for uveitis. Methods The current literature is reviewed and the experience of a tertiary referral centre is reported. Results Chronic non‐infectious uveitis (NU) remains one of the most challenging problems in ophthalmology. Often, early and aggressive treatment is needed for a good visual acuity outcome. Local and oral corticosteroids remain the first line of treatment, even though side effects, such as glaucoma, cataract and Cushing Syndrome, can be serious and not tolerable. Therefore, a variety of immunosuppressive agents are in use, such as Cyclophosphamide, Methotrexate, Cyclosporin A, Azathioprine and Mycophenolate mofetil. Recently, new types of drugs, called “biologic agents”, are available. In the model of experimental autoimmuneuveitis (EAU) it has been demonstrated that tumor necrosis factor‐alpha (TNF‐α) may play a key role in uveitis. Beside other anti‐ TNF‐α drugs, Adalimumab (Humira®) is the newest biologic drug available. Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF‐α that blocks the TNF‐α biologic activity. Adalimumab seems to control uveitis unresponsive to the traditional immunosuppressive agents and, moreover, its subcutaneous administration makes the procedure easier. Conclusion The data in the literature suggest that Adalimumab can be an effective and safe therapy for the uveitis, by controlling inflammation of the eye. The duration of treatment have still to be investigated in larger studies and further trials are mandatory to validate the preliminary data.

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Available abstract

Abstract Purpose To review the current Literature and to describe the experience of a tertiary referral centre on Adalimumab (Humira®) therapy for uveitis. Methods The current literature is reviewed and the experience of a tertiary referral centre is reported. Results Chronic non‐infectious uveitis (NU) remains one of the most challenging problems in ophthalmology. Often, early and aggressive treatment is needed for a good visual acuity outcome. Local and oral corticosteroids remain the first line of treatment, even though side effects, such as glaucoma, cataract and Cushing Syndrome, can be serious and not tolerable. Therefore, a variety of immunosuppressive agents are in use, such as Cyclophosphamide, Methotrexate, Cyclosporin A, Azathioprine and Mycophenolate mofetil. Recently, new types of drugs, called “biologic agents”, are available. In the model of experimental autoimmuneuveitis (EAU) it has been demonstrated that tumor necrosis factor‐alpha (TNF‐α) may play a key role in uveitis. Beside other anti‐ TNF‐α drugs, Adalimumab (Humira®) is the newest biologic drug available. Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF‐α that blocks the TNF‐α biologic activity. Adalimumab seems to control uveitis unresponsive to the traditional immunosuppressive agents and, moreover, its subcutaneous administration makes the procedure easier. Conclusion The data in the literature suggest that Adalimumab can be an effective and safe therapy for the uveitis, by controlling inflammation of the eye. The duration of treatment have still to be investigated in larger studies and further trials are mandatory to validate the preliminary data.

Key concepts: Adalimumab, Uveitis, Medicine, Azathioprine, Infliximab, Dermatology, Adverse effect, Immunology

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