TOPLINE:

Patients with noninfectious intermediate, posterior, or panuveitis requiring immunosuppressive therapy while on prednisone were more likely to have their corticosteroid dose reduced or systemic therapy discontinued while maintaining control of ocular inflammation when treated with adalimumab than when treated with conventional agents.

METHODOLOGY:

• Researchers conducted a trial at uveitis clinics in academic medical centers and private practices across the US and internationally to compare adalimumab with conventional immunosuppressive drugs for treating noninfectious intermediate, posterior, and panuveitis.
• They enrolled 227 participants (mean age, 44 years; 67% women) with active or recently active noninfectious intermediate, posterior, or panuveitis requiring immunosuppression and randomly assigned them to receive adalimumab (n = 114) or conventional immunosuppressive drugs such as antimetabolites and/or calcineurin inhibitors (n = 113).
• Participants were receiving more than 7.5 mg/d prednisone (or prednisolone) or, if their uveitis was recently active, had an anticipated escalation to more than that dose.
• The primary outcome was successful sparing of corticosteroids at 6 months, defined as inactive uveitis while on 7.5 mg/d prednisone or less for two consecutive study visits 28 or more days apart.

TAKEAWAY:

• By 6 months, a higher proportion of participants receiving adalimumab achieved successful sparing of corticosteroids than did those on conventional immunosuppressive therapy (69% vs 54%; adjusted odds ratio [aOR], 1.86; P = .029).
• Successful sparing of corticosteroids was achieved faster in patients receiving adalimumab than in those receiving conventional immunosuppressive therapy (P = .032).
• Successful discontinuation of corticosteroids after 12 months was achieved in 55% of participants on adalimumab vs 40% on conventional immunosuppression (aOR, 1.85; P = .028).
• Rates of cataract surgery were significantly lower in the adalimumab group than in the conventional immunosuppression group (P = .009); both groups maintained best-corrected visual acuity, but participants assigned to conventional immunosuppressive drugs had a higher rate of losing three or more lines of acuity.

IN PRACTICE:

“Adalimumab’s effect was faster for successful corticosteroid sparing by 6 months and a greater proportion had successful corticosteroid discontinuation by 12 months,” the researchers reported.

SOURCE:

This study was led by Douglas A. Jabs, MD, MBA, of the Johns Hopkins Bloomberg School of Public Health in Baltimore. It was published online on October 11, 2025, in Ophthalmology.

LIMITATIONS:

Due to different modes of treatment administration between the groups and among different drugs in the conventional immunosuppression group, study staff and participants were unmasked to treatment assignment. The trial used a novel design in which ophthalmic imaging for assessing disease activity was specific to the type of uveitis each participant had, and not all participants were imaged with the same set of images.

DISCLOSURES:

This study received support through cooperative agreements from the National Eye Institute, National Institutes of Health in Bethesda, Maryland. AbbVie provided adalimumab for the trial. Some authors declared serving as consultants, holding stock options, receiving research funding, and having other ties with various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.