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Outcomes of adalimumab therapy in refractory punctate inner choroidopathy and multifocal choroiditis

  • Inflammatory Disorders
  • Published:
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Abstract

Purpose

This study aims to evaluate the outcomes of adalimumab (ADA) therapy in patients with refractory punctate inner choroidopathy (PIC) and multifocal choroiditis (MFC).

Methods

Demographic and clinical data, including LogMAR best-corrected visual acuity (BCVA), were retrospectively collected. Doses of prednisone, immunomodulatory therapies (IMT), and anti-vascular endothelial growth factor (VEGF) injections before and after baseline (ADA initiation) were recorded, as well as the time to clinical remission, time to first flare, and drug-associated adverse events.

Results

Seven patients (4 females, ten eyes) were included. The mean follow-up after baseline was 17.8 ± 11.1 months (range 6–33). The mean LogMAR BCVA was 0.35 ± 0.77 at 6 months before baseline and remained stable throughout 12 months after baseline (0.31 ± 0.46 at 12 months; p = 0.47). The mean dose of prednisone decreased from 17.3 ± 19.6 mg/day 6 months before baseline (range 0–60) to 2.6 ± 2.4 mg/day at the last follow-up (range 0–6, p = 0.03). The mean number of flares decreased significantly from 1.43 ± 0.79 over a 6-month period before baseline to 0.2 ± 0.45 (p = 0.02) at 6–12 months after baseline. The mean number of anti-VEGF injections was 4.17 ± 3.92 over the 12-month period before baseline, and it was 2.17 ± 3.06 (p = 0.31) during the first 12 months after baseline. No adalimumab-related adverse events were noted.

Conclusion

Adalimumab therapy for refractory PIC/MFC enabled a significant steroid-sparing effect, decreased disease flares, and preserved vision over a mean follow-up of 17.8 months.

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Data availability

The corresponding author has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis as well as the decision to submit for publication

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Or Shmueli & Radgonde Amer

Authors
  1. Or Shmueli
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  2. Radgonde Amer
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Contributions

Conceptualization, RA; methodology, OS and RA; formal analysis and investigation, OS; writing — original draft preparation, OS; writing — review and editing, OS and RA; supervision, RA.

Corresponding author

Correspondence to Radgonde Amer.

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Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional (HMO-Hadassah Medical Organization IRB approved the study) and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent for publication

Not applicable. The study does not contain any patient identifying information.

Conflict of interest

Shmueli, none; Amer, Abbvie lecturer.

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Shmueli, O., Amer, R. Outcomes of adalimumab therapy in refractory punctate inner choroidopathy and multifocal choroiditis. Graefes Arch Clin Exp Ophthalmol 260, 2013–2021 (2022). https://doi.org/10.1007/s00417-021-05539-9

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  • DOI: https://doi.org/10.1007/s00417-021-05539-9

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