The use of adalimumab for relapse in patients with Vogt-Koyanagi-Harada disease
Reviewed by Zina Mobarak

In this retrospective, multi-centre, cohort study, the efficacy and safety of Adalimumab (ADA) treatment for the exacerbation or recurrence of Vogt-Koyanagi-Harada (VKH) patients was assessed by investigating the medical records of patients who had received ADA treatment for more than six months. Seventy patients were included across twelve facilities in Japan, with the mean age of patients being 54.8 ±15.1 years and male:female ratio being 34:36. Sunset glow fundus (SGF) was identified in 71.4% of patients. The background and clinical features of patients prior to initiation of ADA treatment were recorded. It was found that those who received ADA treatment for more than six months had reduced sub-foveal choroidal thickness and indocyanine green angiography scores and their corticosteroid and cyclosporine doses were significantly reduced compared to baseline. Although not statistically significant, LogMAR and flare counts were also improved. A sub-analysis comparing the effect of ADA on VKH patients with and without SGF was done. For patients without SGF, LogMAR visual acuity or flare counts were non-significantly reduced by ADA treatment, however, SFCT, ICGA scores, and mean amounts of corticosteroids were significantly reduced. For patients with SGF, flare counts or SFCT were not significantly reduced, however LogMAR visual acuity, ICGA scores, and mean corticosteroid doses were. Adverse outcomes were identified in 17.1%, including tuberculosis in 7.14% and psoriasis in 2.86%, although ADA treatment was continued in 91.4% of patients. Overall, this study has shown that ADA is effective in achieving remission of ocular inflammation in VKH patients and had a low percentage of serious adverse outcomes. However, some limitations include the use of only Japanese patients and patients being at different stages of chronicity when being given ADA.

Efficacy and safety of adalimumab for exacerbation or relapse of ocular inflammation in patients with Vogt-Koyanagi-Harada disease: a multicenter study.
Nakai A, Takeuchi M, Usui Y, et al.
OCULAR IMMUNOLOGY AND INFLAMMATION
2024;32(4):367–75.