AAO 2025: Adalimumab outperforms conventional immunosuppression in uveitis management

Adalimumab provides superior corticosteroid-sparing and discontinuation rates compared with conventional immunosuppression in non-infectious uveitis, supporting its use as a preferred systemic immunomodulatory agent for patients requiring steroid-sparing therapy. These findings were presented at the American Academy of Ophthalmology's 2025 meeting.

Study details: The ADVISE randomized, unmasked, comparative effectiveness trial enrolled 227 patients with active or recently active non-infectious intermediate, posterior, or panuveitides requiring immunosuppression. Participants were randomized to adalimumab or conventional immunosuppressive drugs (azathioprine, methotrexate, mycophenolate, cyclosporine, or tacrolimus). Primary endpoint: successful corticosteroid sparing (inactive uveitis at prednisone <7.5 mg/day for two consecutive visits >28 days apart) at 6 months; secondary endpoints: corticosteroid sparing at 12 months and complete corticosteroid discontinuation.

Results: At 6 months, 69% of adalimumab-treated patients achieved corticosteroid sparing vs. 54% with conventional immunosuppression (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.06–3.25; P=0.029). By 12 months, 86% in the adalimumab group achieved corticosteroid sparing vs. 77% in the conventional group (OR, 1.89; 95% CI, 0.93–3.83; P=0.077). Corticosteroid discontinuation at 12 months was achieved in 55% with adalimumab vs. 40% with conventional therapy (OR, 1.85; 95% CI, 1.06–3.19; P=0.028).

Source:

Jabs DA, et al. (2025, October 10). Ophthalmology. Adalimumab vs. Conventional Immunosuppression for Uveitis (ADVISE) Trial. https://pubmed.ncbi.nlm.nih.gov/41077357/