Researchers assessed the efficacy of optimized adalimumab therapy in a large series of patients with uveitis due to Behçet disease.

Study design

This open-label multicenter study examined adalimumab-treated patients with Behçet uveitis refractory to conventional immunosuppressants. Patients received optimized or nonoptimized adalimumab dosing interval; optimization was performed in those achieving remission after adalimumab therapy. Intraocular inflammation (anterior chamber cells, vitritis, and retinal vasculitis), macular thickness, visual acuity, and the sparing effect of glucocorticoids were assessed.

Outcomes

Adalimumab was effective in this cohort, leading to improvements in BCVA, macular thickness, and intraocular inflammation signs in both the optimized and nonoptimized groups. This suggests adalimumab optimization is as effective as standard recommended doses. However, two patients in the optimized group relapsed at their last follow-up visit, these patients were successfully treated with the standard adalimumab dose.

Limitations

There was a significant variability in the initial treatment of uveitis within this cohort, which could possibly be a confounding variable.

Clinical significance

This paper describes a large cohort of patients with refractory uveitis due to Behçet disease that were treated with adalimumab. In addition, the authors shared their protocol for adalimumab optimization in refractory uveitis in the paper. Considering the similar efficacy of both adalimumab regimens, optimization appears to be safe and cost-effective in patients with Behçet-related uveitis.