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Adalimumab reduces incidence of uveitis flares in patients with AS, study data show

Sunday, December 09 2007 | Comments

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What's This? Treatment with adalimumab may have a substantial preventive effect on uveitis flares among patients with ankylosing spondylitis, even among those with a history of uveitis, research indicates.

For the prospective, open-label RHAPSODY study, 1,250 patients with active AS who had experienced an unsatisfactory response to standard therapies, including >=1 nonsteroidal antiinflammatory drug, received adalimumab 40 mg every other week for 12 weeks. Patients with anterior uveitis flares within the previous year and/or at baseline received adalimumab for 20 weeks to achieve a longer observation period.

Of the total cohort, 274 patients (22%) had a history of uveitis. Of these patients, 168 (61%) had no symptomatic uveitis, 87 (32%) had 1 to 2 flares, and 19 (7%) had >=3 flares.

Among all of the enrolled patients, the rate of uveitis flares per 100 patient-years fell from 15 before or at baseline to 7.4 during adalimumab therapy.

Among the patients with a history of uveitis, the rate of uveitis flares fell from 68.4 flares per 100 patient-years before or at baseline to a rate of 28.9 flares per 100 patient-years during adalimumab therapy. Moreover, among the patients who had experienced uveitis flares within the previous year, the rate of flares fell from 176.9 flares per 100 patient-years before or at baseline to 56.0 flares per 100 patient-years during adalimumab therapy.

These rates represented a 51% reduction in flare rates among the total cohort, a 58% reduction among the patients with a history of uveitis, and a 68% reduction among those with flares within the previous year.

Overall, 25 patients had an adverse event of uveitis during the study, 2 of whom had no history of uveitis. In contrast, 19 of 28 patients with active uveitis at baseline had no flares during adalimumab therapy.

"Adalimumab effectively reduced the rate of anterior uveitis flares in patients with active AS," the authors concluded. (Rudwaleit M, et al. Poster 578.)

These findings were presented at the 2007 American College of Rheumatology Annual Scientific Meeting.

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