ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1155

Impact of Adalimumab on Immunosuppressant Use in Patients with Active and Inactive Non-Infectious Intermediate, Posterior, or Pan-Uveitis in the Ongoing Open Label Study: Visual-III

Sergio Schwartzman1, Irene Van der Horst-Bruinsma2, Alfredo Adan3, Hiroshi Goto4, Koju Kamoi5, Martina Kron6, Alexandra P. Song7, Kevin Douglas7, Sophia Pathai8 and C. Stephen Foster9, 1Hospital for Special Surgery, New York, NY, 2Department of Rheumatology, VU University Medical Center, Amsterdam, Netherlands, 3Hospital Clinic. Barcelona. Spain, Barcelona, Spain, 4Tokyo Medical University, Tokyo, Japan, 5Tokyo Medical and Dental University, Tokyo, Japan, 6AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany, 7AbbVie Inc., North Chicago, IL, 8AbbVie Ltd, Maidenhead, United Kingdom, 9Massachusetts Eye Research and Surgery foundation and Harvard Medical School, Boston, MA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Monday, November 6, 2017

Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The morbidity associated with the use of immunosuppressants is well described in patients (pts) with autoimmune ophthalmic disease and presents a challenge to treating physicians. The purpose of this analysis was to determine the impact of adalimumab (ADA) on immunomodular (IMM) use in pts with active and inactive non-infectious uveitis in the ongoing open label study: VISUAL-III.

Methods: Adults who met treatment failure criteria1,2 in VISUAL-I/VISUAL-II studies (defined as pts with active uveitis) or who successfully completed the parent studies without treatment failure (defined as pts with inactive uveitis) were eligible to enroll in VISUAL-III and received ADA 40-mg every other week for the study duration. Corticosteroids (CS) and/or IMM therapy were permitted as needed.  For this analysis, proportion of pts on IMM and percent change in systemic IMM dose were analyzed in pts using medications for immunosuppression. Interim follow-up data from VISUAL-III baseline (week 0) through week-78 are described. In addition, proportion of pts who achieved a ≥50% reduction in immunosuppression load (CS + IMM) relative to week 8 (for active uveitis) and relative to week 0 (for inactive uveitis) is reported. Data are presented as-observed. Adverse events are reported from first ADA dose up to the data cut-off date of 31-October-2016.

Results: Of 424 pts enrolled, 371 (active uveitis; n=242 and inactive uveitis; n=129) were included in the intent-to-treat analysis. Of these 371 pts, 117 (32%) (active uveitis; n=65 (56%) and inactive uveitis; n=52 (44%)) were using IMM at VISUAL-III entry. By week 78, the number of pts using IMMs decreased (active uveitis, n=36 and inactive uveitis, n=32). The systemic IMM dose was substantially reduced by week 78 compared to baseline in pts with active and inactive uveitis. In pts with active uveitis using CS + IMM, 47% (52/110) achieved a ≥50% reduction in immunosuppression load relative to week 8, while in pts with inactive uveitis 13% (5/39) achieved a ≥50% reduction in immunosuppression load relative to week 0 (Figure A-B). Adverse Event rates were consistent with previous VISUAL trials.

Conclusion: Long-term treatment with ADA suggests decreased IMM dependence along with substantial reduction in IMM dose in pts with active and inactive uveitis. 

References:

1. Jaffe GJ et. al (2016). NEJM; 375:932-943.

2. Nguyen QD et. al (2016). The Lancet; 388(10050): 1183-1192.

3. Nussenblatt et. al (2005). Ophthalmology; 112 (5):764-770.

Disclosure: S. Schwartzman, Abbvie, Antares, Genentech, Janssen, Lilly, Novartis, Pfizer, Regeneron, Sanofi, and UCB, 5,Abbvie, Janssen, Genentech, Pfizer, UCB, Crescendo, and Novartis, 8; I. Van der Horst-Bruinsma, AbbVie, MSD, UCB, 5,Pfizer, MSD and AbbVie, 2; A. Adan, AbbVie, Santen and Allergan, 9; H. Goto, AbbVie Inc, 9; K. Kamoi, None; M. Kron, AbbVie Inc, 1,AbbVie Inc, 3; A. P. Song, AbbVie Inc, 1,AbbVie Inc, 3; K. Douglas, AbbVie Inc, 1,AbbVie Inc, 3; S. Pathai, AbbVie Inc, 1,AbbVie Ltd, 3; C. S. Foster, Aldeyra (Lexington, MA, USA), Bausch & Lomb Surgical, EyeGate, Novartis, pSivida, and Xoma, 5,Alcon and Allergan, 8,Alcon, Aldeyra, Bausch & Lomb, Clearside Biomedical, Dompe, Icon, Novartis, Santen, Xoma, Aciont and pSivida, 2.

To cite this abstract in AMA style:

Schwartzman S, Van der Horst-Bruinsma I, Adan A, Goto H, Kamoi K, Kron M, Song AP, Douglas K, Pathai S, Foster CS. Impact of Adalimumab on Immunosuppressant Use in Patients with Active and Inactive Non-Infectious Intermediate, Posterior, or Pan-Uveitis in the Ongoing Open Label Study: Visual-III [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/impact-of-adalimumab-on-immunosuppressant-use-in-patients-with-active-and-inactive-non-infectious-intermediate-posterior-or-pan-uveitis-in-the-ongoing-open-label-study-visual-iii/. Accessed .

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