• Elena Silvestri, Alice Bitossi, Alessandra Bettiol, Giacomo Emmi, Maria Letizia Urban, Irene Mattioli, Gerardo Di Scala, Daniela Bacherini, Giuseppe Lopalco, Vincenzo Venerito, Florenzo Iannone, Antonio Vitale, Gian Marco Tosi, Stanislao Rizzo, Claudia Fabiani, Luca Cantarini, Gianni Virgili, Lorenzo Vannozzi, and Domenico Prisco.
• Department of Experimental and Clinical Medicine, University of Firenze, 50134, Florence, Italy.
• Inflammopharmacology. 2020 Jun 1; 28 (3): 711-718.

BackgroundTo compare the efficacy of Adalimumab (ADA) in noninfectious anterior uveitis (AU) and posterior segment (PS) involvement, associated with different conditions, with a focus on Behçet's syndrome (BS).MethodsIn this retrospective, multicenter post-hoc study, we evaluated the efficacy of ADA in terms of ocular control and relapses in 96 patients with AU and PS uveitis, either idiopathic (IU) or associated with BS or with other systemic disorders (OSD) (Juvenile Idiopathic Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Vogt-Koyanagi-Harada, Inflammatory Bowel Disease), followed in three tertiary referral centers.ResultsNinety-six patients (45 AU; 51 PS uveitis) were included. Eleven had IU, 58 BS, and 27 OSD. All patients with AU achieved complete long-term ocular control. In PS uveitis, 89%, 67% and 100% of patients with BS, IU and OSD achieved ocular control at the last follow-up (> 12 months), respectively. The lowest ocular relapse rate occurred in patients with AU with BS (1/13) or IU (0/2). ADA accounted for long-term disease control, and no predictors of ocular control and relapse were identified; particularly, ocular relapses seemed not related to systemic ones. Macular edema resolved in 75% and 67% of PS uveitis with BS and IU, respectively.ConclusionsADA controls both anterior and posterior uveitis, with an efficacy similar in IU, BS and OSD patients. In BS, the efficacy of ADA seems to be independent of demographic and clinical characteristics, and ocular relapses mostly occurred independently from systemic ones. Based on our results, ADA may represent a valid alternative in anterior refractory uveitis.

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