PMID- 35845536
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220719
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 10
IP  - 12
DP  - 2022 Jun
TI  - Systemic glucocorticoid-free therapy with adalimumab plus immunosuppressants 
      versus conventional therapy in treatment-naive Vogt-Koyanagi-Harada disease 
      patients.
PG  - 699
LID - 10.21037/atm-22-2668 [doi]
LID - 699
AB  - BACKGROUND: High dose systemic glucocorticoid is the main therapy of 
      treatment-naive Vogt-Koyanagi-Harada (VKH) disease. However, series side effects 
      induced by high dose systemic glucocorticoid frequently occur, which makes 
      alternative therapy necessary for certain patients. This study sought to compare 
      the efficacy and safety of systemic glucocorticoid-free (SGF) therapy with 
      conventional therapy (CT) as an initial treatment for VKH patients. METHODS: VKH 
      patients who had not been systemically treated were enrolled. Patients were 
      allocated into 2 therapeutic groups depending on their treatments. In CT group, 
      patients received systemic glucocorticoid plus immunosuppressants (IS), and in 
      SGF group, patients received adalimumab (ADA) plus IS. Patients received 
      approximately 12 months treatment and visit monthly. The outcome parameters 
      included the changes of best-corrected visual acuity (BCVA), intraocular 
      inflammation (including anterior chamber cell grade and vitritis grade) and 
      central macular thickness (CMT) (the change values define as the final-visit 
      values subtracted from baseline counterparts). Other outcomes included the 
      relapses times of ocular inflammation, adverse events (AEs), changes of optic 
      nerve inflammation (ONI) and intraocular/extraocular manifestations. RESULTS: A 
      total of 30 patients (60 eyes) were included. with 19 patients (38 eyes) in CT 
      group and 11 patients (22 eyes) in SGF group. After approximately 1 year of 
      treatment, the improvements of BCVA were slight better in the SGF group 
      (0.57+/-0.23) than in the CT group (0.40+/-0.26), (P=0.014). In both groups, the 
      ocular inflammatory improvements in both groups were similar, with an improvement 
      of AC cell grade of -1.5 (-2, -0.5) in CT group versus -1 (-2, -1) in SGF group 
      (P=0.367); improvement of vitritis grade was 0 (-1.25, 0) in CT group and -1 (-1, 
      -1) in SGF group (P=0.050). The improvement in CMT was similar in both groups, 
      with -523.47+/-412.09 microm in CT group and -362.73+/-375.73 microm in SGF group (P=0.572). 
      The mean number of relapses was 1 (0, 2) in the CT group and 0 (0, 2) in the SGF 
      group (P=0.372). No severe AEs were observed in this study. CONCLUSIONS: SGF 
      therapy is effective, safe, and well-tolerated in treatment-naive VKH patients. 
      SGF therapy seems to be a feasible option in patients with existing systemic 
      diseases intolerant to glucocorticoid.
CI  - 2022 Annals of Translational Medicine. All rights reserved.
FAU - Yang, Shizhao
AU  - Yang S
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Tao, Tianyu
AU  - Tao T
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Li, Zhaohuai
AU  - Li Z
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Chen, Binyao
AU  - Chen B
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Huang, Zhaohao
AU  - Huang Z
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Liu, Xiuxing
AU  - Liu X
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Li, He
AU  - Li H
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Xie, Lihui
AU  - Xie L
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
FAU - Feng, Wen
AU  - Feng W
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
AD  - Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 
      China.
FAU - Su, Wenru
AU  - Su W
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou, China.
AD  - Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 
      China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC9279783
OTO - NOTNLM
OT  - Adalimumab
OT  - Vogt-Koyanagi-Harada (VKH)
OT  - glucocorticoid-free
OT  - treatment-naive
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://atm.amegroups.com/article/view/10.21037/atm-22-2668/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/07/19 06:00
MHDA- 2022/07/19 06:01
PMCR- 2022/06/01
CRDT- 2022/07/18 03:50
PHST- 2022/04/11 00:00 [received]
PHST- 2022/06/20 00:00 [accepted]
PHST- 2022/07/18 03:50 [entrez]
PHST- 2022/07/19 06:00 [pubmed]
PHST- 2022/07/19 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - atm-10-12-699 [pii]
AID - 10.21037/atm-22-2668 [doi]
PST - ppublish
SO  - Ann Transl Med. 2022 Jun;10(12):699. doi: 10.21037/atm-22-2668.