Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry

Antonio Vitale; Francesca Della Casa; Silvana Guerriero; Gaafar Ragab; Angela Mauro; Valeria Caggiano; Marco Cattalini; Emanuela Del Giudice; Rossella Favale; Carla Gaggiano; Irene Bellicini; Maria Pia Paroli; Mohamed Tharwat Hegazy; Jurgen Sota; Abdurrahman Tufan; Alberto Balistreri; Ibrahim Almaghlouth; Francesco La Torre; Ewa Więsik-Szewczyk; Maria Tarsia; Andrea Hinojosa-Azaola; Eduardo Martín-Nares; Bruno Frediani; Gian Marco Tosi; Alex Fonollosa; José Hernández-Rodríguez; Rana Hussein Amin; Giuseppe Lopalco; Donato Rigante; Luca Cantarini; Claudia Fabiani

doi:10.1007/s40123-023-00712-1

Ophthalmology and Therapy (May 2023)

Efficacy and Safety of Adalimumab in Pediatric Non-infectious Non-anterior Uveitis: Real-life Experience From the International AIDA Network Uveitis Registry

Antonio Vitale,
Francesca Della Casa,
Silvana Guerriero,
Gaafar Ragab,
Angela Mauro,
Valeria Caggiano,
Marco Cattalini,
Emanuela Del Giudice,
Rossella Favale,
Carla Gaggiano,
Irene Bellicini,
Maria Pia Paroli,
Mohamed Tharwat Hegazy,
Jurgen Sota,
Abdurrahman Tufan,
Alberto Balistreri,
Ibrahim Almaghlouth,
Francesco La Torre,
Ewa Więsik-Szewczyk,
Maria Tarsia,
Andrea Hinojosa-Azaola,
Eduardo Martín-Nares,
Bruno Frediani,
Gian Marco Tosi,
Alex Fonollosa,
José Hernández-Rodríguez,
Rana Hussein Amin,
Giuseppe Lopalco,
Donato Rigante,
Luca Cantarini,
Claudia Fabiani

Affiliations

Antonio Vitale: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Francesca Della Casa: Department of Translational Medical Sciences, Section of Clinical Immunology, University of Naples Federico II
Silvana Guerriero: Department of Ophthalmology and Otolaryngology, University of Bari
Gaafar Ragab: Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University
Angela Mauro: Department of Pediatrics, Rheumatology Unit, ASST Fatebenefratelli-Sacco
Valeria Caggiano: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Marco Cattalini: Pediatric Clinic, University of Brescia and Spedali Civili di Brescia
Emanuela Del Giudice: Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome
Rossella Favale: Department of Ophthalmology and Otolaryngology, University of Bari
Carla Gaggiano: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Irene Bellicini: Pediatric Clinic, University of Brescia and Spedali Civili di Brescia
Maria Pia Paroli: Department of Sense Organs, Eye Clinic, Uveitis Unit, Sapienza University of Rome
Mohamed Tharwat Hegazy: Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Cairo University
Jurgen Sota: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Abdurrahman Tufan: Department of Internal Medicine and Rheumatology, Gazi University
Alberto Balistreri: Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena
Ibrahim Almaghlouth: Department of Medicine, College of Medicine, Rheumatology Unit, King Saud University
Francesco La Torre: Pediatric Rheumatology Center, Department of Pediatrics, Ospedale “Giovanni XXIII”, AOU Consorziale Policlinico
Ewa Więsik-Szewczyk: Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, National Research Institute
Maria Tarsia: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Andrea Hinojosa-Azaola: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Eduardo Martín-Nares: Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Bruno Frediani: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Gian Marco Tosi: Department of Medicine, Surgery and Neurosciences, Ophthalmology Unit, ERN RITA Center, University of Siena
Alex Fonollosa: Department of Ophthalmology, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country
José Hernández-Rodríguez: Vasculitis Research Unit and Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona
Rana Hussein Amin: Ophthalmology Department, Faculty of Medicine, Cairo University
Giuseppe Lopalco: Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J) Policlinic Hospital, University of Bari
Donato Rigante: Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS
Luca Cantarini: Research Center of Systemic Autoinflammatory Diseases and Behçet’s Disease Clinic, ERN RITA Center, Rheumatology-Ophthalmology Collaborative Uveitis Center, Department of Medical Sciences, Surgery and Neurosciences, University of Siena
Claudia Fabiani: Department of Medicine, Surgery and Neurosciences, Ophthalmology Unit, ERN RITA Center, University of Siena

DOI: https://doi.org/10.1007/s40123-023-00712-1
Journal volume & issue: Vol. 12, no. 4
pp. 1957 – 1971

Abstract

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Abstract Introduction Scientific evidence of the effectiveness of the tumor necrosis factor inhibitor adalimumab (ADA) in pediatric patients with non-infectious non-anterior uveitis is still limited. The aim of this study is to investigate the therapeutic role of ADA in a cohort of pediatric patients with non-anterior uveitis. Methods This is an international multicenter study analyzing real-life data referred to pediatric patients treated with ADA for intermediate uveitis/pars planitis, posterior uveitis and panuveitis. Data were drawn from the AutoInflammatory Disease Alliance (AIDA) registry for patients with uveitis. Results Twenty-one patients (36 affected eyes) were enrolled, and all patients benefited from ADA administration. In detail, 11 patients (19 affected eyes) did not experience further ocular inflammation after ADA introduction; 10 cases (17 affected eyes) showed a significant clinical improvement consisting of a decrease in severity and/or frequency of ocular relapses. The number of ocular flares dropped from 3.91 to 1.1 events/patient/year after ADA introduction (p = 0.0009); macular edema and retinal vasculitis were respectively observed in 18 eyes and 20 eyes at the start of ADA and in 4 eyes and 2 eyes at the last assessment. The mean daily glucocorticoid dosage significantly decreased from 26.8 ± 16.8 mg/day at the start of ADA to 6.25 ± 6.35 mg/day at the last assessment (p = 0.002). Intermediate uveitis/pars planitis (p = 0.01) and posterior uveitis (p = 0.03) were more frequently observed in patients with full response to ADA; panuveitis (p = 0.001) was significantly more frequent among patients continuing to experience uveitic flares. This could be related to a higher use of systemic glucocorticoids (p = 0.002) and conventional immunosuppressants (p = 0.007) at the start of ADA when treating intermediate uveitis/pars planitis. Regarding the safety profile, only one adverse event was reported during ADA treatment, consisting of the development of generalized adenopathy. Conclusions ADA proved to have an effective therapeutic role in all pediatric patients with non-anterior uveitis enrolled in the study. An overall glucocorticoid-sparing effect was observed despite the severity of cases enrolled. A more aggressive treatment of panuveitis and posterior uveitis at start of ADA could increase the likelihood of full response to therapy.

Published in Ophthalmology and Therapy

ISSN: 2193-8245 (Print); 2193-6528 (Online)
Publisher: Adis, Springer Healthcare
Country of publisher: United Kingdom
LCC subjects: Medicine: Ophthalmology
Website: https://www.springer.com/journal/40123

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