Efficacy and safety of adalimumab in the treatment of non-infectious uveitis: a meta-analysis and systematic review
Authors Ming S, Xie K, He H, Li Y, Lei B
Received 20 December 2017
Accepted for publication 30 April 2018
Published 4 July 2018 Volume 2018:12 Pages 2005—2016
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Anastasios Lymperopoulos
Shuai Ming,1,2 Kunpeng Xie,1,2 Huijuan He,1,2 Ya Li,1,2 Bo Lei1–3
1Clinical Reserach center, Henan Eye institute, Henan Eye hospital, 2Department of Ophthalmology, Henan Provincial People’s Hospital, 3Department of Ophthalmology, People’s Hospital of Zhengzhou University, Zhengzhou, China
Objective: To summarize updated evidences on the efficacy and safety of adalimumab (ADA) in the treatment of patients with non-infectious uveitis.
Patients and methods: A systematic search between January 2000 and September 2017 was conducted using PubMed, Embase, and Cochrane libraries. We investigated control of inflammation, improvement of visual acuity (VA), corticosteroid-sparing effect, and adverse events (AEs) or serious adverse events.
Results: Three randomized clinical trials (RCTs) and 20 non-RCTs were included and analyzed. The pooled proportions of inflammation control were 74% (95% CI 64%–82%) and 79% (95% CI 69%–87%) in groups of ≤6- and ≥12-months follow-up durations. No significant difference was found between the two groups (χ2 = 0.920, p = 0.337). Analysis of subgroups classified by degree of being treatment-naïve for anti-TNFα agents showed the inflammation control reached a high of 87% (95% CI 80%–92%) when subjects were “almost naïve” to anti-TNFα before ADA treatment. VA was improved by three or more lines in 41.3% (52/126) eyes, and was equal to or better than the baseline in 88.8% (142/160) eyes. Corticosteroid sparing was observed in 82.0% (91/111) of the patients; among them, 48.8% (40/82) discontinued use of corticosteroid completely. Minor drug-related adverse events were reported. The treatment effects of ADA were generally consistent in the three RCTs, and ADA reduced the risk of treatment failure by 43%–75%.
Conclusion: The current review provided evidences that ADA might be a promising choice in reducing inflammatory activity, gaining VA, and sparing corticosteroid use with minor AEs when applied in treating non-infectious uveitis.
Keywords: adalimumab, non-infectious uveitis, anti-TNF α, uveitis treatment
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