Tuesday, 17 Sep 2019

You are here

Adalimumab Controls Non-Infectious Uveitis in VISUAL II Study

It has long been observed that patients receiving monoclonal antibody based anti-TNF (TNFi) therapies for spondylitis or psoriatic disease have less inflammatory eye complications, such as uveitis. These agents have become common interventions based on these observational results. But now we have randomized controlled trials to prove the efficacy of TNF blockade in non-infectious uveitis.

The VISUAL II trial is a worldwide, multicenter, blinded, randomised, placebo-controlled phase 3 study of 229 adults with inactive, non-infectious intermediate, posterior, or panuveitic uveitis controlled by 10–35 mg/day of prednisone. All patients underwent a mandatory prednisone taper and the primary endpoint was time to treatment failure, based on ocular assessments.

After a median follow-up time was 155 days, treatment failure occurred in 55% of the placebo group and 39% of those on adalimumab. The time to treatment failure was significantly longer in the adalimumab group compared with the placebo group (>18 months vs 8·3 months, respectively).

There were no unusual or notable safety signals from either group. 

Adalimumab significantly lowered the risk of uveitic flare or loss of visual acuity upon corticosteroid withdrawal in patients with inactive, non-infectious intermediate, posterior, or panuveitic uveitis. 

Adalimumab is FDA approved for the treament of on-infectious intermediate, posterior, or panuveitic uveitis.

The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Anti-IL-23 Beats IL-17 in Plaque Psoriasis

Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).

Taltz FDA Approved for Ankylosing Spondylitis (Radiographic Axial SpA)

The FDA has approved the IL-17A inhibitor Taltz (ixekizumab) for the treatment of adults with active ankylosing spondylitis (AS: also known as radiographic axial spondyloarthritis).  

The recommended dose is 160 mg SC (two 80 mg injections) at Week 0, followed by 80 mg every 4 weeks.  The updated package insert can be found here.

ACR/SPARTAN Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis

The American College of Rheumatology (ACR), in partnership with the Spondylitis Association of America (SAA) and the Spondyloarthritis Research and Treatment Network (SPARTAN), released the 2019 Update of the Recommendations for the Treatment of Ankylosing Spondylitis (AS) and Nonradiographic Axial Spondyloarthritis (nr-axSpA).

Skyrizi Outduels Humira in Psoriasis

A head-to-head trial has shown that risankizumab was significantly superior to adalimumab in providing skin clearance (PASI90) in patients with moderate-to-severe plaque psoriasis, with no difference in safety signals between the two agents.

Biologic Therapy Improves Psoriasis and Reduces CV Inflammation

Psoriasis confers a significant risk of comorbidity, but is psoriasis associated with increased coronary inflammation and is this risk attenuated by biologic therapy? JAMA Cardiology has published a cohort study of 134 consecutive patients with moderate to severe psoriasis, showing that biologic therapy was associated with a significant decrease in coronary inflammation as assessed by perivascular fat attenuation index, a marker of coronary inflammation associated with cardiovascular outcomes. Patients not receiving biologic therapy had no change in perivascular fat attenuation index at 1 year.