Comparison of infliximab with adalimumab for the treatment of non-infectious uveitis: a systematic review and meta-analysis.

BMC Ophthalmol

Department of Ophthalmology, Ankang Hospital of Traditional Chinese Medicine, No. 47 Bashan East Rd., Hanbin Dist, Ankang City, 725000, China.

Published: May 2023

AI Article Synopsis

  • The study aimed to compare how effective and safe infliximab is compared to adalimumab in treating non-infectious uveitis (NIU).
  • After analyzing 11 clinical trials involving 1,459 patients, the results showed no significant differences in complete remission rates or therapy responses between the two drugs.
  • However, the analysis indicated that infliximab had a higher rate of adverse events (17.91%) compared to adalimumab (12.12%), suggesting that adalimumab is slightly safer.

Article Abstract

Purpose: To compare the efficacy and safety of infliximab with that of adalimumab in the treatment of non-infectious uveitis (NIU).

Methods: We searched for relevant studies in the PubMed, Embase, ClinicalTrials.gov, Cochrane Library databases, Grey Matters, Grey Literature Report, OpenGrey, China National Knowledge Infrastructure (CNKI), and Wan Fang databases up to September 2022. The incidences of complete remission of inflammation, response to therapy, adverse events and corticosteroid-sparing effect were evaluated.

Results: Eleven clinical trials covering 1459 NIU patients were included. Complete remission of inflammation after therapy was achieved in 161 (37.5%) patients in the infliximab group and 151 (39.6%) patients in the adalimumab group. These two groups were not significantly different (P = 0.37). Four studies reported response to anti-TNF therapy involving 449 patients, of whom 241/272 (88.6%) treated with infliximab and 153/177 (86.4%) treated with adalimumab achieved partial or complete remission of inflammation. No significant difference was observed between the two cohorts in terms of response to therapy (P = 0.86). There was no significant difference between infliximab and adalimumab with regard to corticosteroid-sparing effect (P = 0.58). The pooled effect size (P = 0.001) showed a statistically significant difference, with the incidence of adverse events being 17.91% for infliximab and 12.12% for adalimumab.

Conclusion: Our systematic review and meta-analysis of 11 studies suggests that infliximab and adalimumab have similar therapeutic efficacy and corticosteroid-sparing effect in patients with NIU. However, adalimumab has a marginal advantage over infliximab in terms of adverse events. Large-scale RCTs with a longer follow-up are required to further evaluate these two anti-TNF-α agents in patients with NIU.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226205PMC
http://dx.doi.org/10.1186/s12886-023-02987-1DOI Listing

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