Efficacy of Adalimumab with dose-reduced glucocorticoid for the treatment of Vogt-Koyanagi-Harada disease
10.3980/j.issn.1672-5123.2022.12.26
- VernacularTitle:阿达木单抗和糖皮质激素减量治疗Vogt-小柳原田综合征的疗效
- Author:
Yan-Chao GUI
1
;
Mei DUAN
1
;
Yi-Ming GUAN
1
;
Si-Yu GUI
1
;
Qin-Yu NI
1
;
Li-Ming TAO
1
;
Zheng-Xuan JIANG
1
Author Information
1. Department of Ophthalmology, the Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
- Publication Type:Journal Article
- Keywords:
Adalimumab;
tumor necrosis factor-α;
Vogt-Koyanagi-Harada disease;
glucocorticoid;
efficacy
- From:
International Eye Science
2022;22(12):2068-2072
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To evaluate the clinical efficacy of adalimumab(ADA)with dose-reduced glucocorticoid for the treatment of Vogt-Koyanagi-Harada disease(VKH).METHODS: A total of 21 patients(37 eyes)with VKH who received ADA therapy in the Department of Ophthalmology of our hospital from August 2020 to December 2021 were included. The interval of ADA administration was progressively extended after intraocular inflammation controlled and lasted for 3mo, and it returned to the initial treatment interval once the inflammation recurred. After follow-up for 12mo, anterior chamber cell(ACC)grade, vitreous haze(VH)grade, retinal/choroidal lesions, serous retinal detachment(SRD), best corrected visual acuity(BCVA), central macular thickness(CMT)and doses of glucocorticoid and immunosuppressant were compared before and after the first ADA injection. Treatment failure events and adverse reactions were recorded.RESULTS: Compared with baseline, the proportion of eyes with ACC grade ≤1+ and VH grade ≤1+ increased(P<0.05), the proportion of eyes with retinal/choroidal lesions decreased significantly(P<0.01), BCVA and CMT were significantly improved(P<0.01), and the average dose of glucocorticoid reduced significantly(P<0.01)at 2wk, 1, 3 and 6mo after treatment. At the final follow-up, 82% of patients received glucocorticoid ≤5 mg, and all patients stopped using immunosuppressant. There were 13 treatment failure events during the follow-up period, and 12 patients(57%)extended the ADA treatment interval, with no serious adverse events related to ADA treatment observed.CONCLUSION: ADA is effective and safe for the treatment of VKH, reducing the need for glucocorticoid and immunosuppressant. In addition, extending the interval of ADA treatment is effective, which has a lower recurrence rate.
