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Title: Adalimumab Decreases Rate of Anterior Uveitis in Ankylosing Spondylitis: Presented at AAO

"Adalimumab Decreases Rate of Anterior Uveitis in Ankylosing Spondylitis: Presented at AAO"

By Emma Hitt, PhD ATLANTA -- November 11, 2008 -- The anti-tumour necrosis factor inhibitor adalimumab appears to effectively inhibit the development of anterior-uveitis episodes in patients with ankylosing spondylitis, according to new research presented here at the American Academy of Ophthalmology (AAO) annual meeting. Approximately 20% to 40% of patients with ankylosing spondylitis have at least 1 episode of anterior uveitis during the course of their disease. Uveitis is considered to be responsible for approximately 10% of cases of blindness in the United States, noted Hartmut Kupper, MD, Abbott, Ludwigshafen, Germany, speaking here at a poster session on November 10. Adalimumab is a fully human monoclonal antibody that is approved in the United States for the treatment of ankylosing spondylitis, as well as for rheumatoid arthritis, psoriatic arthritis, Crohn's disease, moderate to severe chronic psoriasis, and juvenile idiopathic arthritis. A large cohort of patients with ankylosing spondylitis was examined from the Review of Safety and Effectiveness With Adalimumab in Patients With Active Ankylosing Spondylitis (RHAPSODY) trial. The prospective RHAPSODY trial was designed to examine the efficacy and safety of 12 weeks of treatment with adalimumab 40 mg subcutaneously every other week in 1,250 patients. A medical history of anterior uveitis confirmed by an ophthalmologist was documented at baseline for every patient with active ankylosing spondylitis enrolled in the trial. Anterior uveitis was characterised as acute or chronic (persistent anterior uveitis is a symptom-free interval of less than 3 months to the next relapse). Patients with anterior uveitis flares within the prior year before or at baseline received 20 weeks of treatment with adalimumab. Among the cohort of patients, 1 to 2 flares of anterior uveitis were reported in 87 patients, and at least 3 flares were reported in 19 patients, representing a combined total of 187.5 uveitis flares occurring the year before or at baseline. The percentage of anterior uveitis that was observed during adalimumab treatment was significantly reduced compared to baseline. Overall, the number of anterior uveitis flares was reduced from 15 flares/100 patient-years at baseline to 7.4 flares/100 patient-years during adalimumab treatment (51% reduction; [P < .001).

The greatest reduction with adalimumab was observed in patients with anterior-uveitis flares in the past 12 months, which were reduced from 176.9 flares/100 patient-years at baseline to 56 flares/100 patient-years during adalimumab treatment (68% decline). In addition, the rate of anterior-uveitis flares was reduced by 58% in patients with any history of anterior uveitis, by 50% in patients with symptomatic anterior uveitis at baseline, and by 45% in patients with chronic uveitis.

"The majority of anterior-uveitis flares during adalimumab treatment were considered mild (67%) or moderate (29%) by the treating physician," the researchers noted.

"The anti-inflammatory action of adalimumab that makes it effective in ankylosing spondylitis is likely responsible for the decrease in anterior-uveitis flares," Dr. Kupper said.

Funding for this study was provided by Abbott.

[Presentation title: Tumor Necrosis Factor-Antagonist Adalimumab Inhibits Uveitis Flares in Patients With Ankylosing Spondylitis. Abstract PO437]

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