1. 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

2. 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

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

4. Case 4

5. 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

6. 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

7. 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.