Efficacy of Adalimumab Therapy for Non-Infectious Uveitis in Japanese Patients: Methotrexate Concomitance Across Different Uveitis Etiologies and the Effect of Dose Spacing

PURPOSE: To evaluate the long-term efficacy of adalimumab (ADA) in Japanese patients with non-infectious uveitis (NIU), with particular attention to etiologic differences in methotrexate (MTX) requirements and the feasibility of ADA dose spacing. METHODS: This retrospective study included patients with chronic NIU or sclerouveitis treated with ADA for more than 6 months. Data included ocular inflammation control, systemic corticosteroid dose, and MTX use. The prespecified primary time point was 12 months. The primary endpoints were patient-level inactive uveitis and change in oral corticosteroid dose. Eye-level outcomes were analyzed using mixed-effects models and generalized estimating equations. Survival analysis compared MTX requirements among etiologies, and dose spacing outcomes and adverse events were also assessed. RESULTS: = 0.035 at 12 months) and inflammation markers. Inactive uveitis was observed in 61.5% (48/78) at 12 months. Patients with late- or chronic-stage Vogt-Koyanagi-Harada disease/sympathetic ophthalmia showed a trend toward a higher requirement for MTX concomitance than Behçet's disease patient. Over half of the 24 patients attempting dose spacing relapsed (14/24), but disease control was regained by shortening intervals. The median relapse-free survival was 20.8 months (95% CI 14.5-25.2). CONCLUSION: ADA effectively controlled NIU and provided significant steroid-sparing benefits. Possible etiology-dependent differences in MTX requirements and relapse risk during dose spacing, support the optimization of individualized, closely monitored treatment.