Early administration of adalimumab for paediatric uveitis due to Behçet’s disease

Hiyama, Tomona; Harada, Yosuke; Doi, Takehiko; Kiuchi, Yoshiaki

doi:10.1186/s12969-019-0333-6

Cited by 18 publications

(13 citation statements)

References 31 publications

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“…Thirty articles included for the final review are composed of two systematic reviews with metaanalysis [11,12], fifteen case reports/series [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], and thirteen observational studies [1,3,4,9,[28][29][30][31][32][33][34][35][36][37]. The two systematic reviews provided data on 692 patients.…”

Section: Resultsmentioning

confidence: 99%

“…The US Food and Drug Administration (FDA) eventually approved adalimumab as the only anti-TNF agent for use in adult NIU based on the findings of the VISUAL I, II, and subsequently, VISUAL III studies. Hiyama et al, in 2019, published a report of two cases of Behcet's uveitis treated successfully with adalimumab after it became refractory to steroids [ 13 ].…”

Section: Reviewmentioning

confidence: 99%

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Biologic Therapies in Sarcoidosis and Uveitis: A Review

Ogbue¹,

Malhotra²,

Akku³

et al. 2020

Cureus

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Sarcoidosis and uveitis are chronic inflammatory conditions with potentially debilitating effects on quality of life. Steroids form the mainstay standard therapy in both conditions. Biologic agents are considered to be appropriate alternatives for treatment in steroid-refractory sarcoidosis and uveitis due to the role of tumor necrosis factor (TNF) in mediating the inflammatory cascade seen in both conditions. We performed a thorough literature search using PubMed to compare the extent of use, efficacy, and safety profile of individual anti-TNF agents in the management of these conditions. Our review consists of two systematic reviews with meta-analysis, thirteen observational studies, and fifteen case series/reports. Infliximab had the widest range of organ-system usage in extra-pulmonary sarcoidosis but is equivalent to adalimumab in terms of efficacy. In uveitis, adalimumab was found to be the most efficacious agent for maintaining disease remission in adults and children with chronic non-infectious uveitis. Etanercept was neither used widely, nor was it efficacious in the management of either condition. In terms of safety profile, biologic agents were found to be well tolerated and have a similar safety profile. More randomized clinical trials are needed to inform evidence-based use of biologic agents in these conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Biologic Therapies in Sarcoidosis and Uveitis: A Review

Ogbue¹,

Malhotra²,

Akku³

et al. 2020

Cureus

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“…Though the efficacy of ADA in retinal vasculitis seemed inspiring, the primary disease of their patients was not solely confined to BU, and patients with spondylarthritis, Crohn’s disease and some unmentioned diseases were also included. In Asia, sporadic studies have reported similar outcomes, including Far Eastern areas such as Japan and Hong Kong ( Bawazeer et al, 2010 ; Al-Fakhri and Alsulaiman, 2019 ; Hiyama et al, 2019 ; Ho et al, 2019 ).…”

Section: Discussionmentioning

confidence: 96%

The Efficacy of Adalimumab as an Initial Treatment in Patients with Behçet’s Retinal Vasculitis

Yang

Huang

et al. 2021

Front. Pharmacol.

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Background: No study has evaluated the effectiveness of Adalimumab (ADA) as first-line in treatment-naïve patients with retinal vasculitis due to Behçet’s Uveitis (BU).Objective: To compare the efficacy of ADA plus conventional therapy and conventional therapy alone as initial treatments in naïve BU patients characterized by retinal vasculitis.Methods: Medical records of BU patients characterized by retinal vasculitis treated with conventional therapy (CT, refers to glucocorticoid and immunosuppressive agents) alone or ADA plus conventional therapy with at least 6 months of follow-up between February 2015 and June 2020 were analyzed. Only patients who were first diagnosed with BU without previous systemic treatment were reviewed. The retinal vasculitis score based on fluorescein angiography (FA), best-corrected visual acuity, glucocorticoid-sparing effect, the number of relapses and ocular complications were evaluated.Results: A total of 45 patients (87 eyes) were included. Twenty-four patients (55.33%) in the CT group were treated with conventional therapy and 21 patients (46.67%) in the ADA group were treated with ADA plus conventional therapy. The inflammatory parameters improved in both groups. FA scores showed significantly greater improvement in ADA group than CT group (p < 0.001). The median number of relapses was significantly lower, and the duration of remission was longer in ADA group than CT group (p < 0.001). At the last visit, a significantly better BCVA improvement (p = 0.024), better inflammation control (anterior chamber inflammation p = 0.017 and vitritis p < 0.001) and lower daily glucocorticoid dosage (p = 0.005) were identified in patients received ADA therapy. In CT group, 1 patient suffered hepatitis B and tuberculosis, 1 had growth retardation, 1 patient had with osteoporosis, then followed by other mild AEs (mostly respiratory upper tract infections); while in ADA group, 1 patient experienced a mild pneumonia (n = 1) while milder AEs were represented mostly by respiratory upper tract infections followed by gastrointestinal discomfort.Conclusion: ADA plus conventional therapy achieved superiority over conventional therapy as initial treatment in naïve BU patients with retinal vasculitis.

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“…The recommendation for the treatment of pediatric BD has been recently updated. In particular, the use of anti-TNFα drugs as a second-line option for refractory BD, and as a first-line treatment in severe ocular and neurological involvement, has demonstrated to be effective in improving the outcome of BD patients ( 10 , 18 ). In our case child developed cataracts due to long use of corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Adalimumab in Treatment of Uveitis in Pediatric Behcet's Disease-a Case Report

Halilbasic¹,

Vodencarevic²,

Ćosićkić³

et al. 2021

Mater Sociomed

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Introduction: Behcet’s Disease (BD) is an inflammatory disease characterized by multisystemic involvement and featured by a chronic, relapsing disease course. Recurrent ocular inflammation and macular involvement may lead to severe loss of visual acuity. Prolonged use of local and systemic corticosteroids lead to numerous side effects and complications. Very often other immunosuppressive therapies are needed. Biologic agents are promising for the treatment of Behcet’s disease-associated uveitis. Aim: To report successful treatment of paediatric uveitis due to incomplete Behçet’s disease with administration of adalimumab, after failing to react to all other modalities of treatment. Case report: We present the case of a 15-year-old girl who was treated for reccurent uveitis in both eyes with developed complications on anterior and posterior ocular segment. She was earlier treated with topical and systemic steroids for uveitis, laser photocoagulation and methotrexate, however, relapses occurred inspite all treatment modalities. Patient was diagnosed with incomplete Behcet’s disease, and adalimumab therapy was initiated. Inflammation was well-controlled by adalimumab administration without need for local or systemic corticosteroids. Conclusion: Adalimumab is effective for treating children with Behcet’s disease-associated uveitis. Control of ocular inflammation in our case was achieved without need for continuing local or systemic corticosteroids, thus preventing further complications and possible significant vision loss.

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Early administration of adalimumab for paediatric uveitis due to Behçet’s disease

Cited by 18 publications

References 31 publications

Biologic Therapies in Sarcoidosis and Uveitis: A Review

Biologic Therapies in Sarcoidosis and Uveitis: A Review

The Efficacy of Adalimumab as an Initial Treatment in Patients with Behçet’s Retinal Vasculitis

Adalimumab in Treatment of Uveitis in Pediatric Behcet's Disease-a Case Report

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