Noninfectious uveitis relapse lower with infliximab vs adalimumab

Among patients with sight-threatening noninfectious uveitis (NIU), those treated with infliximab are less likely to relapse than those who received adalimumab, a study has found.

The observational retrospective multicentre study included 330 patients (median age 36 years, 45.2 percent male) with sight-threatening NIU (ie, retinal vasculitis and/or macular oedema). These patients were treated with antitumour necrosis factor (anti-TNF) alpha agents—either intravenous infliximab (5 mg/kg at weeks 0, 2, 6 and every 4–6 weeks) or subcutaneous adalimumab (80 mg then 40 mg every 2 weeks).

Researchers looked at the medical records of patients and collected data on relapse rate, complete response of NIU, corticosteroid sparing effect, and safety.

Behçet's disease was the most common aetiology of uveitis included (27 percent), followed by idiopathic juvenile arthritis (5.8 percent) and sarcoidosis (5.5 percent). The estimated relapse rate at 6 months after introduction of biological agents was 13 percent (95 percent confidence interval [CI], 0.009–0.16).

Compared with adalimumab, infliximab was associated with a lower risk of relapse (hazard ratio [HR], 0.52, 95 percent CI, 0.36–0.77; p=0.001). However, the two drugs were similar in terms of complete response rate of NIU and corticosteroid-sparing effect.

Of note, patients with Behçet's disease were more likely to achieve complete response (HR, 2.04, 95 percent CI, 1.16–3.60; p=0.01) and less likely to relapse (HR, 0.53, 95 percent CI, 0.33–0.85; p=0.009) with an anti-TNF alpha agent as compared with patients with other causes of NIU.