Background: No study has evaluated the effectiveness of
Adalimumab (ADA) as first-line in treatment-naïve patients with
retinal vasculitis due to Behçet's
Uveitis (BU). Objective: To compare the efficacy of ADA plus conventional
therapy and conventional
therapy alone as initial treatments in naïve BU patients characterized by
retinal vasculitis. Methods: Medical records of BU patients characterized by
retinal vasculitis treated with conventional
therapy (CT, refers to
glucocorticoid and
immunosuppressive agents) alone or ADA plus conventional
therapy with at least 6 months of follow-up between February 2015 and June 2020 were analyzed. Only patients who were first diagnosed with BU without previous systemic treatment were reviewed. The
retinal vasculitis score based on
fluorescein angiography (FA), best-corrected visual acuity,
glucocorticoid-sparing effect, the number of relapses and ocular complications were evaluated. Results: A total of 45 patients (87 eyes) were included. Twenty-four patients (55.33%) in the CT group were treated with conventional
therapy and 21 patients (46.67%) in the ADA group were treated with ADA plus conventional
therapy. The inflammatory parameters improved in both groups. FA scores showed significantly greater improvement in ADA group than CT group (p < 0.001). The median number of relapses was significantly lower, and the duration of remission was longer in ADA group than CT group (p < 0.001). At the last visit, a significantly better BCVA improvement (p = 0.024), better
inflammation control (anterior chamber
inflammation p = 0.017 and vitritis p < 0.001) and lower daily
glucocorticoid dosage (p = 0.005) were identified in patients received ADA
therapy. In CT group, 1 patient suffered
hepatitis B and
tuberculosis, 1 had growth retardation, 1 patient had with
osteoporosis, then followed by other mild AEs (mostly respiratory upper tract
infections); while in ADA group, 1 patient experienced a mild
pneumonia (n = 1) while milder AEs were represented mostly by respiratory upper tract
infections followed by gastrointestinal discomfort. Conclusion: ADA plus conventional
therapy achieved superiority over conventional
therapy as initial treatment in naïve BU patients with
retinal vasculitis.