Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy
Background: No study explores the effectiveness of adalimumab in sight-threatening Vogt-Koyanagi-Harada (VKH) patients in China.Objective: To evaluate the short-term effectiveness and safety of adalimumab (ADA) in patients with sight-threatening Vogt-Koyanagi-Harada (VKH) disease refractory to conve...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.799427/full |
| _version_ | 1828132537299369984 |
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| author | Shizhao Yang Tianyu Tao Zhaohao Huang Xiuxing Liu He Li Lihui Xie Feng Wen Feng Wen Wei Chi Wei Chi Wenru Su Wenru Su |
| author_facet | Shizhao Yang Tianyu Tao Zhaohao Huang Xiuxing Liu He Li Lihui Xie Feng Wen Feng Wen Wei Chi Wei Chi Wenru Su Wenru Su |
| author_sort | Shizhao Yang |
| collection | DOAJ |
| description | Background: No study explores the effectiveness of adalimumab in sight-threatening Vogt-Koyanagi-Harada (VKH) patients in China.Objective: To evaluate the short-term effectiveness and safety of adalimumab (ADA) in patients with sight-threatening Vogt-Koyanagi-Harada (VKH) disease refractory to conventional therapy.Methods: Medical records of VKH patients who had been treated with systemic glucocorticoids and immunosuppressants but whose condition was poorly controlled were collected and analyzed. Primary outcomes comprised of best-corrected visual acuity (BCVA), intraocular inflammation, relapses, and glucocorticoid-sparing effects. Other outcomes included central macular thickness (CMT), intraocular manifestations and adverse events (AEs).Results: Nine refractory VKH patients with a median age of 30 (16, 43) years old were enrolled in this study and received treatment for a median of 10 (7, 11) months. Mean BCVA improved from LogMar 0.63 ± 0.50 (20/72 or 0.36 ± 0.26 in Snellen chart) at baseline to LogMar 0.50 ± 0.37 (20/82 or 0.41 ± 0.28 in Snellen chart) at final visit (P = 0.090). The anterior chamber cell grade decreased from 2 (1.75, 3)+ at baseline to 0.5 (0, 1.25)+ cell at final visit (P < 0.001). The vitritis grade decreased from 1 (1, 1) + cell at baseline to 0 (0, 1)+ cell at final visit (P < 0.001). Patients suffered a median of 1 (0, 2) relapse during treatment. CMT remained stable from 238.50 ± 144.94 μm at baseline to 219.28 ± 77.20 μm at final visit (P = 0.553). The mean prednisone dosage decreased from 21.91 ± 18.39 mg/d to 2.73 ± 4.10 mg/d (P = 0.005). No severe AEs were found during treatment.Conclusions: The outcomes indicated that ADA was an effective and safe option for VKH patients refractory to conventional therapy by controlling inflammation, preserving visual function and reducing the daily glucocorticoid dose. |
| first_indexed | 2024-04-11T17:06:24Z |
| format | Article |
| id | doaj.art-e6f321b8b79e43498aa8bcf3bb14836b |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T17:06:24Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-e6f321b8b79e43498aa8bcf3bb14836b2022-12-22T04:13:01ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-01-01810.3389/fmed.2021.799427799427Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional TherapyShizhao Yang0Tianyu Tao1Zhaohao Huang2Xiuxing Liu3He Li4Lihui Xie5Feng Wen6Feng Wen7Wei Chi8Wei Chi9Wenru Su10Wenru Su11State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, ChinaState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, ChinaBackground: No study explores the effectiveness of adalimumab in sight-threatening Vogt-Koyanagi-Harada (VKH) patients in China.Objective: To evaluate the short-term effectiveness and safety of adalimumab (ADA) in patients with sight-threatening Vogt-Koyanagi-Harada (VKH) disease refractory to conventional therapy.Methods: Medical records of VKH patients who had been treated with systemic glucocorticoids and immunosuppressants but whose condition was poorly controlled were collected and analyzed. Primary outcomes comprised of best-corrected visual acuity (BCVA), intraocular inflammation, relapses, and glucocorticoid-sparing effects. Other outcomes included central macular thickness (CMT), intraocular manifestations and adverse events (AEs).Results: Nine refractory VKH patients with a median age of 30 (16, 43) years old were enrolled in this study and received treatment for a median of 10 (7, 11) months. Mean BCVA improved from LogMar 0.63 ± 0.50 (20/72 or 0.36 ± 0.26 in Snellen chart) at baseline to LogMar 0.50 ± 0.37 (20/82 or 0.41 ± 0.28 in Snellen chart) at final visit (P = 0.090). The anterior chamber cell grade decreased from 2 (1.75, 3)+ at baseline to 0.5 (0, 1.25)+ cell at final visit (P < 0.001). The vitritis grade decreased from 1 (1, 1) + cell at baseline to 0 (0, 1)+ cell at final visit (P < 0.001). Patients suffered a median of 1 (0, 2) relapse during treatment. CMT remained stable from 238.50 ± 144.94 μm at baseline to 219.28 ± 77.20 μm at final visit (P = 0.553). The mean prednisone dosage decreased from 21.91 ± 18.39 mg/d to 2.73 ± 4.10 mg/d (P = 0.005). No severe AEs were found during treatment.Conclusions: The outcomes indicated that ADA was an effective and safe option for VKH patients refractory to conventional therapy by controlling inflammation, preserving visual function and reducing the daily glucocorticoid dose.https://www.frontiersin.org/articles/10.3389/fmed.2021.799427/fulladalimumabTNF-α inhibitorVogt-Koyanagi-Harada (VKH)refractorytreatment |
| spellingShingle | Shizhao Yang Tianyu Tao Zhaohao Huang Xiuxing Liu He Li Lihui Xie Feng Wen Feng Wen Wei Chi Wei Chi Wenru Su Wenru Su Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy Frontiers in Medicine adalimumab TNF-α inhibitor Vogt-Koyanagi-Harada (VKH) refractory treatment |
| title | Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy |
| title_full | Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy |
| title_fullStr | Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy |
| title_full_unstemmed | Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy |
| title_short | Adalimumab in Vogt-Koyanagi-Harada Disease Refractory to Conventional Therapy |
| title_sort | adalimumab in vogt koyanagi harada disease refractory to conventional therapy |
| topic | adalimumab TNF-α inhibitor Vogt-Koyanagi-Harada (VKH) refractory treatment |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.799427/full |
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