Researchers have discovered that adalimumab is an effective non-steroidal treatment for noninfectious uveitis, which causes eye inflammations.
Sold as Humira, adalimumab was originally approved by the U.S. Food and Drug Administration (FDA) as a treatment for arthritis and Crohn's disease. The drug's effectiveness in treating noninfectious uveitis is surprising because corticosteroids are the usual treatment options approved by the FDA for treating the condition, although doctors have prescribed adalimumab for off-label use.
According to Dr. Glenn Jaffe, senior author of a study published in the New England Journal of Medicine, adalimumab treats patients with uveitis by homing in on a protein believed to be responsible for inflammation.
"Patients may have many unwanted side effects when taking steroids long-term, as many uveitis patients do," he said, adding that the goal of their research was to see if there is an alternative treatment out there that would not only minimize or replace steroid use but is also more effective and safe.
For the study, Jaffe and colleagues worked with 217 adults with noninfectious posterior or intermediate uveitis. Randomly grouped, the subjects were assigned to get either adalimumab or placebo when the study began as well as every two weeks afterward. All the subjects were also given usual doses of prednisone, a cortocosteroid, initially, and kept receiving doses in diminishing amounts over a 15-week period.
The subjects were assessed based on how soon they met treatment failure or saw a worsening or recurrence in at least one of the signs of inflammation: more cloudiness in the gel filling the eye, more inflammatory cells in front of the eye, reduced visual clarity or new inflammation in the back of the eye.
According to the researchers, they focused on timing treatment failure as delaying, and ultimately preventing, inflammations is a crucial component of a successful treatment. Their hope is that with the delay or elimination of recurrence, symptoms of uveitis will not just be minimized but cleared as well.
Symptoms of uveitis, like floaters in the eye and eye pain, are caused by active inflammation, which is the result of the immune system fighting itself. Sometimes, a permanent reduction in vision also occurs.
Based on their findings, the researchers put median time until treatment failure is reached at 13 weeks for the placebo group and 24 weeks in those administered adalimumab. Additionally, those in the adalimumab group had dramatically lower chances of treatment failure within the study period and had lower treatment failure risks because of the inflammation signs outlined by the researchers.
Unfortunately, the adalimumab group also experienced adverse side effects - like allergic reactions and infections in the respiratory tract - more frequently compared to the group given placebo.
Photo: Mike Fernwood | Flickr
