Safety and Efficacy of Adalimumab in Patients with Noninfectious Uveitis in an Ongoing Open-Label Study: VISUAL III

Suhler, Eric B.; Adán, Alfredo; Brézin, Antoine P.; Fortin, Éric; Gotô, Hiroshi; Jaffe, Glenn J.; Kaburaki, Toshikatsu; Kramer, Michal; Lim, Lyndell L; Muccioli, Cristina; Nguyen, Quan Dong; Calster, Joachim Van; Cimino, Luca; Kron, Martina; Song, Alexandra P.; Liu, Jianzhong; Pathai, Sophia; Camez, Anne; Schlaen, Ariel; Velthoven, Mirjam E. J. van; Vitale, Albert T.; Zierhut, Manfred; Tari, Samir; Dick, Andrew D.

doi:10.1016/j.ophtha.2017.12.039

Cited by 156 publications

(130 citation statements)

References 35 publications

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“…There were no new safety signals observed, with the rate of adverse events similar to previously reported studies. A follow‐up trial showed that patients with active uveitis who received adalimumab were likely to achieve disease quiescence, improvement in visual acuity and reduce their systemic corticosteroid use, consistent with the results of previous trials …”

Section: Tnf‐α Inhibitorssupporting

confidence: 85%

“…A follow-up trial showed that patients with active uveitis who received adalimumab were likely to achieve disease quiescence, improvement in visual acuity and reduce their systemic corticosteroid use, consistent with the results of previous trials. 53 Though they are both TNF-α inhibitors, adalimumab has some preliminary advantages over infliximab. First, adalimumab offers greater patient independence due to its subcutaneous (s.c.) route of administration, allowing patients the option of self-injection that does not require hospitalisation, thereby increasing compliance and reducing institution costs.…”

Section: Adalimumabmentioning

confidence: 99%

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The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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The uveitides are a heterogenous group of ocular inflammatory disorders that account for the third highest cause of blindness worldwide, responsible for 5–10% of visual impairment globally. Up to 35% of patients with uveitis can suffer significant vision loss. To prevent irreversible structural damage and blindness, it is important that the diagnosis and commencement of appropriate therapy occurs promptly. Management includes topical and systemic corticosteroid therapy and conventional immunomodulatory agents, including methotrexate, azathioprine, mycophenolate mofetil and cyclosporin. Significant progress has been made in the past decade in our understanding of the immunopathological pathways that drive intraocular inflammation, allowing the development of targeted therapy with biologic agents. These include TNF‐α inhibitors, such as infliximab, adalimumab and etanercept; interleukin blockers, such as tocilizumab and daclizumab; and other targeted therapies, such as rituximab and abatacept. The efficacy of these agents has been studied in cases of severe uveitis that are refractory to conventional immunomodulatory agents and provide exciting results that have revolutionised uveitis management. Though the biologic era has provided a large armamentarium to treat uveitis, ongoing challenges and cases of recalcitrant uveitis remain, posing a challenge to internal medicine physicians. This comprehensive review aims to construct an updated summary on the existing evidence pertaining to the use of biologic agents in the treatment of uveitis. Methods include a systematic search for studies between 2000 and 2018 using PubMed, EMBASE, Ovid MEDLINE and Cochrane libraries.

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Section: Tnf‐α Inhibitorssupporting

confidence: 85%

Section: Adalimumabmentioning

confidence: 99%

The use of biologic agents in the management of uveitis

Trivedi

Katelaris

2019

Internal Medicine Journal

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“…Preliminary data are available from a conference abstract. 91 This states that, of 243 patients with active uveitis after 78 weeks, 96.3% had no new inflammatory lesions relative to week 8, 91.0% had an AC cell grade of ≤ 0.5+ and 87.8% had a VH grade of ≤ 0.5+. Of 128 patients with inactive uveitis after 54 weeks, 98.5% had no new inflammatory lesions relative to baseline, 98.5% had an AC cell grade of ≤ 0.5+ and 92.6% had a VH grade of ≤ 0.5+.…”

Section: Ongoing Studiesmentioning

confidence: 97%

A systematic review and economic evaluation of adalimumab and dexamethasone for treating non-infectious intermediate uveitis, posterior uveitis or panuveitis in adults

Squires

Poku

Bermejo

et al. 2017

Health Technol Assess

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Declared competing interests of authors: Fahd Quhill has received personal fees from Allergan for participation in medical education and training, and has participated in advisory boards given his clinical expertise in the role of steroids in diabetic macular oedema. He has also received support from Allergan to attend international conferences.Published November 2017 DOI: 10.3310/hta21680 This report should be referenced as follows: This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was commissioned and funded by the HTA programme on behalf of NICE as project number 15/64/07. The protocol was agreed in June 2016. The assessment report began editorial review in December 2016 and was accepted for publication in May 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expre...

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“…The median time to treatment failure was also significantly higher in the adalimumab group (>18 months) compared to 8.3 months of the placebo group ( P < .05). The patients who completed VISUAL I and II with and without treatment failure were given an option to enrol into the open‐label extension study for these trials, namely VISUAL III . All the patients in VISUAL III received 40 mg subcutaneous adalimumab every other week.…”

Section: Current Therapiesmentioning

confidence: 99%

“…The patients who completed VISUAL I and II with and without treatment failure were given an option to enrol into the open-label extension study for these trials, namely VISUAL III. 97 All the patients in VISUAL III received 40 mg subcutaneous adalimumab every other week. The interim results at week 70 demonstrate that 60% of the patients with active uveitis had achieved quiescence, whereas 74% of the patients who had inactive disease remained inactive with most of them not needing any systemic corticosteroids.…”

Section: Adalimumabmentioning

confidence: 99%

New therapies in development for the management of non‐infectious uveitis: A review

Hassan

Karkhur

Bae

et al. 2019

Clinical Exper Ophthalmology

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Uveitis is a spectrum of inflammatory disorders characterized by ocular inflammation and is one of the leading causes of preventable visual loss. The main aim of the treatment of uveitis is to control the inflammation, prevent recurrences of the disease and preserve vision while minimizing the adverse effects associated with the therapeutic agents. Initial management of uveitis relies heavily on the use of corticosteroids. However, monotherapy with high‐dose corticosteroids is associated with side effects and cannot be maintained long term. Therefore, steroid‐sparing agents are needed to decrease the burden of steroid therapy. Currently, the therapeutic approach for non‐infectious uveitis (NIU) consists of a step‐ladder strategy with the first‐line option being corticosteroids in various formulations followed by the use of first‐, second‐ and third‐line agents in cases with suboptimal steroid response. Unfortunately, the agents currently at our disposal have limitations such as having a narrow therapeutic window along with their own individual potential side‐effect profiles. Therefore, research has been targeted to identify newer drugs as well as new uses for older drugs that target specific pathways in the inflammatory response. Such efforts are made in order to provide targeted and safer therapy with reduced side effects and greater efficacy. Several specially designed molecular antibodies are currently in various phases of investigations that can potentially halt the inflammation in patients with NIU. In the review, we have provided a comprehensive overview of the current and upcoming therapeutic options for patients with NIU.

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Safety and Efficacy of Adalimumab in Patients with Noninfectious Uveitis in an Ongoing Open-Label Study: VISUAL III

Cited by 156 publications

References 35 publications

The use of biologic agents in the management of uveitis

The use of biologic agents in the management of uveitis

A systematic review and economic evaluation of adalimumab and dexamethasone for treating non-infectious intermediate uveitis, posterior uveitis or panuveitis in adults

New therapies in development for the management of non‐infectious uveitis: A review

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