Intravitreal Adalimumab in Active Noninfectious Uveitis: A Pilot Study

Hamam, Rola N.; Barikian, Anita; Antonios, Rafic; Abdulaal, Marwan; Alameddine, Raafat; Mollayess, Georges El; Mansour, Ahmad M.

doi:10.3109/09273948.2014.990041

Cited by 37 publications

(59 citation statements)

References 24 publications

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“…In Hamam et al. (), only the change in median CMT between baseline and final visit (week 26) was reported, being statistically significant. About the OCT device used to assess the macula, two studies used a spectral‐domain OCT device (Androudi et al.…”

Section: Resultsmentioning

confidence: 92%

“…(); (iii) change in the grade of inflammatory anterior chamber cells and vitreous haze, change in fluorescein angiography (FA) score, change in CMT on OCT and change in electrophysiological tests in Hamam et al. (); (iv) change in BCVA, change in the grade of inflammatory anterior chamber cells, vitreous haze and posterior segment in Markomichelakis et al. (); and (v) change in BCVA, change in CMT on OCT, change in vitreous haze, number of patients with retinitis, vasculitis and papilitis and change in electrophysiological tests in Hamza et al.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Leal

Rodrigues

Sousa

et al. 2018

Acta Ophthalmologica

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Anti-tumour necrosis factor (TNF) drugs have been extensively used in non-infectious uveitis (NIU), when corticosteroids or conventional immunosuppressive drugs cannot adequately control inflammation or intolerable side-effects occur. However, systemic anti-TNF therapies are also associated with a myriad of side-effects. Therefore, intravitreal administration of anti-TNF biologics has been employed to minimize patient morbidity and systemic adverse effects, while maintaining therapeutic effectivity. We undertook a systematic review to determine evidence of efficacy and safety of intravitreal administration of anti-TNF drugs in adults with NIU. We conducted this systematic review according to the PRISMA guidelines. The protocol was registered with PROSPERO (CRD42016041946). We searched CENTRAL, MEDLINE and EMBASE, from inception to April 2017, as well as clinical trial registries and grey literature. The qualitative analysis included all studies of adult patients with a diagnosis of NIU and who received intravitreal anti-TNF drugs with a 4-week minimum follow-up. A total of 4840 references were considered for title and abstract screening. Seven full texts were screened, and five studies were considered for analysis. All studies were open-label, single-centre, prospective, non-randomized, interventional case series with a follow-up between 4 and 26 weeks, employing either adalimumab in two studies and infliximab in three. Three studies showed a treatment effect of anti-TNF intravitreal injections, while one study revealed short-term improvement and one study revealed no efficacy of anti-TNF intravitreal therapy. None of the studies reported ocular adverse effects but only two studies included electrophysiological assessment in the safety analysis and no study assessed systemic human anti-drug antibodies. The available evidence is not sufficiently robust to conclude about the clinical effectivity of intravitreal anti-TNF in NIU and so no recommendation can be made. In conclusion, intravitreal injection of anti-TNF antibodies remains a possible treatment option to be explored through robust clinical investigation.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Leal

Rodrigues

Sousa

et al. 2018

Acta Ophthalmologica

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“…The safety and efficacy of intraocular adalimumab have been tested in humans with refractory macular cystic edema secondary to noninfectious uveitis. While efficacy was not shown, there were no adverse ocular or systemic effects [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Role of Systemic Anti-Tumor Necrosis Factor Alpha Treatment in the Reduction of Proliferative Vitreoretinopathy

Rosa¹,

Fernandez²,

Lipski³

2015

J Clin Exp Ophthalmol

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Objective: Proliferative vitreoretinopathy (PVR) is still one of the most serious complications of rhegmatogenous retinal detachment (RRD) because there is no effective treatment or prophylaxis. Tumor necrosis factor α (TNFα) has been implicated in the development of PVR. Thus, the blockade of this factor could reduce or prevent the onset of PVR. However, systemic treatment with anti-TNFα has some risks and side effects, and the use of these drugs in this situation is not yet justified. Therefore we sought an indirect approach to determine if systemic anti-TNFα provided any protection against the development of PVR after RRD surgery. We attempted to estimate the rate of RRD and PVR in patients who were treated systemically with anti-TNFα drugs because of autoimmune diseases and who also had surgically-treated RRD.Methods: Nine centers participated in this retrospective, observational study of cases and controls. Two different approaches were used to find cases and controls. The records at five clinical centers of patients who were under anti-TNFα treatment for chronic inflammatory systemic diseases between January 2004 and 2014 were reviewed to determine how many developed RRD. Additionally, the records in eight clinical centers of patients who underwent RRD surgery during this same period were reviewed to determine the numbers who were simultaneously receiving anti-TNFα treatment. Cases included patients treated with anti-TNFα treatment whereas controls were those who were not under anti-TNFα treatment. Both patients and controls had systemic inflammatory disease. The main outcome measure was development of PVR after RRD surgery at three months follow-up.Results: A total of 8,017 medical records from nine different centers were reviewed. Among the 1,884 patients with anti-TNFα treatment and 6,133 patients operated for primary RRD, only 3 controls and 1 case were identified.Conclusions: An insufficient number of patients were identified to allow any valid conclusion regarding our hypothesis that systemic anti-TNFα therapy could reduce the onset of PVR after RRD surgery. Nevertheless, this indirect approach could be useful for future research in PVR prevention.

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“…Development of permanent antibodies against adalimumab was associated with undetectable trough adalimumab levels and worse uveitis outcomes in non-responders. The short-term efficacy of intravitreal adalimumab (IVA) for the treatment of eyes with active non-infectious uveitis was reported by Hamam et al 10 . Six patients (12 eyes) completed 26 weeks of IVA treatment.…”

Section: Biological Agentsmentioning

confidence: 97%

Recent advances in managing and understanding uveitis

Chen

Sheu

2017

F1000Res

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Uveitis is a sight-threatening disease entity with intraocular inflammation that arises from various causes. It mainly affects working-age individuals and may lead to irreversible visual loss if not treated properly in a timely manner. This article reviews recent advances in the management and understanding of uveitis since 2014, including treatment with new immunosuppressive therapies that use biological agents, local therapy with steroid implants, and imaging studies for the evaluation of uveitis.

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Intravitreal Adalimumab in Active Noninfectious Uveitis: A Pilot Study

Cited by 37 publications

References 24 publications

Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Efficacy and safety of intravitreal anti‐tumour necrosis factor drugs in adults with non‐infectious uveitis – a systematic review

Role of Systemic Anti-Tumor Necrosis Factor Alpha Treatment in the Reduction of Proliferative Vitreoretinopathy

Recent advances in managing and understanding uveitis

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