Optical coherence tomographic image before Humira treatment showing swelling in the retina (cystoid macular edema).
06 Optical coherence tomographic image six weeks after Humira treatment showing complete resolution of retinal swelling. The vision improved from 20/80 to 20/20 following Humira treatment.
“At the same time, novel ways of giving the drugs locally, like the Medidur system, allow our patients to be free of many of the really dangerous or intolerable systemic side effects that are caused by steroids and even some of the immune-suppressing medications that we’re giving to the whole body just to treat the eye,” he notes. “And if we can give this treatment in the clinic rather than the operating room, that’s even better.” The results of the Humira and Medidur studies are significant not only because they indicate that these treatments delay or eliminate inflammation recurrence, but also because investigators assessed several conditions associated with treatment failure: new areas of inflammation in the back of the eye, reduced visual clarity, more inflammatory cells in the front of the eye, and/or more cloudiness of the vitreous gel that fills the eye. (Most ophthalmology drug studies focus solely on the patient’s visual acuity as an endpoint.) “Using these multiple, composite endpoints was something unique, and likely the way uveitis studies are headed,” Jaffe says. “Since each of these signs can be associated with different types of uveitis, the studies’ results broaden the applicability of treatment for patients experiencing flare and vision impairment associated with this group of inflammatory diseases of the eye.” The dearth of new FDA-approved treatments for uveitis before now was not for lack of trying, Jaffe makes clear. “There have been several drug studies that failed to yield positive results, so these successes are particularly exciting, and we are looking forward to several other potential new treatments that are now in the pipeline.” V DUKE EYE CENTER