Efficacy Of Adalimumab In Combination With Systemic Glucocorticoids In The Treatment Of Severe Or Refractory Noninfectious Uveitis

Objective:Evaluation of the effects of systemic corticosteroid-based adalimumab therapy in patients with non-infectious uveitis by observation of ocular inflammation.Ocular inflammatory conditions were determined by best-corrected visual acuity,central macular thickness,anterior chamber cell grading and vitreous haze determination.Methods:A retrospective clinical cohort study.Study Subjects:Patients with severe or refractory noninfectious uveitis who sought care at the objective hospital between December 2021 and January 2023.27 eyes of 16 patients were registered.Process:Medical records were gathered according to inclusion and exclusion criteria.In addition to basic corticosteroid therapy,adalimumab is administered to patients with severe and refractory noninfectious uveitis.Tuberculosis and other infections were precluded before treatment.Additional patients experienced repeated episodes of inflammation despite previous treatment,and as in this study,therapy will need to be initiated with systemic corticosteroid therapy.Ocular inflammation was periodically monitored during treatment.Analysis of changes in best-corrected visual acuity, central macular thickness,anterior chamber cell grading and vitreous haze determination.at baseline,two weeks,month 1,month 2,month 3,month 6,month 9and month 12 after initiation of treatment.SPSS 26.0 was used to process the data.Results:At baseline,27 eyes showed inflammatory activation.Median log MRA visual acuity has an obvious reduction at treated patients.（p=0.009,α=0.05）Anterior chamber cells grades（ACCG）declined significantly in the first month.（₁=0.02,α=0.05）Vitreous haze determination（VHD）decreases visibly in the second month.（₂=0.04,α=0.05）After the third month,ACCG and VHD became steady.The central macular thickness appears to shrink over the two weekends and reaches a significant level at month 12(₁₂=0.001409,α’=0.00179).Conclusions:Adalimu in combination with corticosteroids in rapid succession is effective and safe in controlling intraocular inflammation in severe and refractory noninfectious uveitis,potentially suppressing inflammation at an early stage and preventing vision-threatening complications.