Adalimumab and infliximab as treatment of refractory Vogt-Koyanagi-Harada Lucía Ibares-Frías, José María Herreras-Cantalapiedra Hospital Clínico Universitario de Valladolid Instituto Universitario de Oftalmobiología Aplicada (IOBA) 29th Spanish Uveitis Study Group Meeting

Objective Methods 29th Spanish Uveitis Study Group Meeting The aim of this study is to assess the efficacy and safety of Biologic response modifiers (BRMs), adalimumab and infliximab in treating refractory Voght-Koyanagi-Harada (VKH) Methods Retrospective analysis of case series of resistant VKH to Conventional Immunosuppressive (CIS) treatment

Figures: Pictures of the VKH patients included in the study Case 3

Case 4

Poor control of uveitis 29th Spanish Uveitis Study Group Meeting Results Table 1: Demographics of the patients included Patient number 1 2 3 4 Age 65 58 48 41 Sex Female Previous CIS treatment Pred, CsA Pred Pred, CsA,AZP End of follow up CIS treatment CsA Pred,CsA Pred, AZP Pred: Prednisone, CsA: cyclosporine, AZP: azathioprine I A Table 2: Swithching Previous BRM Infliximab Adalimumab End of follow up BRM Time for switching (months) 17 32 NO 28 Reason for switching Poor control of uveitis Liver intolerance Months in treatment with last BRMs 34 6 37 BRMs withdrawal

29th Spanish Uveitis Study Group Meeting Table 3: Outcomes VKH Infliximab (3s) Pre (M±DE) n=3 Post (M±DE) p valor Adalimumab n=4 AVMC 0.67±0.60 0.71±0.56 0. 870 0.80±0.51 0.61±0.61 0. 516 Células CA 0.67±0.51 0.35±0.0.39 0. 309 0.51±0.44 0.12±0.23 0. 041* Células VA 1.16±0.75 0.50±0.83 0. 147 1.00±1.3 0.87±1.64 0. 544 Carga IM 10.00±6.26 2.00±2.36 0. 023* 3.25±1.05 0.50±0.90 0. 007* * Statistically significant differences (p<0.05) Patients were treated with Infliximab: 5mg/kg every 6 weeks for 22± 3.09 months Adalimumab: 40mg every other week for 16.50±9.40 months

29th Spanish Uveitis Study Group Meeting Conclusions Adalimumab and infliximab seems to be an effective and safe treatment for Vogt- Koyanagi-Harada refractory to conventional treatment and may reduce immunomodulation requirement.