Book

Abstract Book
U n ive rs i t a rio de Va l e n c i a ), G a rc i a - D e l p e ch Salva d o r
(Hospital General Universitario de Valencia), Amselem Luis
(Hospital General Universitario de Valencia)
Introduction and Objectives: To compare the safety and
effcacy of Daclizumab and Infliximab for the treatment of
uncontrolled noninfectious intermediate uveitis, posterior
uveitis and panuveítis.
Methods: Prospective nonrandomized interventional trial
over 20 patients with noninfectious intermediate uveitis, posterior
uveitis and panuveítis with a history of at least one
relapse in their ocular inflammation during 6 months prior to
the beginning of the study in spite of treatment with systemic
corticosteroids and 1 or more immunosuppressive drugs. 10
patients were treated with Daclizumab (1mg/kg) every 4
weeks and 10 more patients were treated with Infliximab
(5mg/kg) every 8 weeks. The groups were equally distributed
regarding the type of the uveitis and the systemic immunosuppression
medication load. The main outcome measures
were the Early Treatment of Diabetic Study (EDTRS) visual
acuity, the systemic immunosuppression medication load and
the ocular inflammation using standardized grading scales.
Patients were examined every 3 months for a follow-up time
of 12 moths.
Results: 7 of 10 patients (70%) in the Daclizumab treatment
group didn’t show any relapse of their ocular inflammation,
6 patients of the Daclizumab treatment group reduced their
systemic corticosteroid dose until 5 mg/day. 10 of 10 patients
(100%) in the Infliximab treatment group didn’t show any
re l apse of their ocular infl a m m ation. 8 patients of the
Infliximab treatment group reduced their systemic corticosteroid
dose until 5 mg/day. No side effects were observed
during the follow-up in any of the groups, but Infliximab
s h owed some minor re a c t i o n s , l i ke hypotension and
h e a d a ch e, d u ring the administration of the medicat i o n .
Conclusions: Infliximab had a higher rate of success in controlling
the ocular inflammation in these patients and it was
clearly more effective in patients with Behçet disease. No
serious side effects were observed with Daclizumab and
Infliximab but caution is needed during the administration of
Infliximab.
Financial fundings: None
Conflict of interest: The authors have no financial interest
in this study
Keywords: Daclizumab, Infliximab, Noninfectious Uveitis
PO3-24-07
EVALUATION OF SAFETY AND EFFICACY OF
ADALIMUMAB IN THE TREATMENT OF NONIN-
FECTIOUS UVEITIS.
Diaz-Llopis Manuel (Hospital General Unive rs i t a rio de
Va l e n c i a , S p a i n ), Salom David (Hospital Genera l
Universitario de Valencia, Spain), Amselem Luis (Hospital
General Universitario de Valencia, Spain), Udaondo Patricia
(Hospital General Universitario de Valencia, Spain), Garcia-
D e l p e ch Salvador (Hospital General Unive rs i t a rio de
Va l e n c i a , S p a i n ), H e rn a n d e z - G a r fella Marisa (Hospital
General Universitario de Valencia, Spain)
I n t roduction and Objective s : A d a l i mu m ab is a 100%
h u m a n i zed monoclonal antibody with an anti Tu m o r
Necrosis Factor (TNF) activity with the advantage of the subcutaneous
administration. The purpose of this study is to
evaluate the efficacy and safety of subcutaneous adalimumab
for therapy-resistant uveitis.
Methods: Nineteen consecutive patients with bilateral, sightthreatening,
non-infectious uveitis with chronic dependence
on immunosuppressive drugs were treated with adalimumab
40 mg every other week for one year. Main outcome measures:
1) Best-corrected visual acuity; 2) Degree of ocular
i n fl a m m ation ;3) Ability to reduce immu n o s u p p re s s ive
d rugs; 4) Lack of clinical re c u rrences; 5) Macular
edema(OCT). Clinical success was judged by the composite
clinical end point of the five different outcome measures.
R e s u l t s : All patients demonstrated a rapid and go o d
response. Nineteen patients (100%) met criteria for clinical
success at the one year follow-up. Visual acuity: 30 of 38
eyes (78.94%) improved, 6 eyes (15.78%) presented no
change and 2 eyes (5.26%) had continued visual loss.
A n t e rior seg m e n t : 21 eyes (55.26%) presented re d u c e d
inflammation and 17 eyes (44.73%) had no change. Posterior
segment: 29 eyes (76.31%) had demonstrated rapid response
and achieved disease improvement, 9 eyes (23.68%) presented
no change, and no eyes worsened. Concomitant immunosuppressive
drugs were reduced by at least 50% in 19
p atients (100%) and there we re no seve re re c u rre n c e s .
Macular thickness was significantly reduced from 390.63 ±
138.18 μ to 241.05 ± 64.63 μ (p < 0.05) at the end of followup.
No adverse effects were observed.
Conclusions: Adalimumab seems to be an effective and safe
t h e rapy for the management of re f ra c t o ry uve i t i s , a n d
appears to reduce the need for concomitant immunosuppressive
treatment.
Financial fundings: None
Conflict of interest : The authors have no financial interest
in this study
Keywords: Adalimumab, Noninfectious uveitis, Treatment
9 th International Ocular Inflammation Society (IOIS) Congress
September 17-20, 2007, Paris, France
179