Graefes Arch Clin Exp Ophthalmol. 2026 Jun 5. doi: 10.1007/s00417-026-07293-2. Online ahead of print.
ABSTRACT
BACKGROUND: To conduct a comparative analysis of the efficacy and safety profiles of Tofacitinib (Tofa) and Adalimumab (ADA) in individuals diagnosed with refractory Behçet’s uveitis.
METHODS: A retrospective analysis was conducted on the medical records of 64 patients who received Tofa (n = 30) or ADA (n = 34) in routine clinical practice. Treatment allocation was not randomized. The analysis focused on drug response rate, central macular thickness, ocular inflammation parameters, and best-corrected visual acuity at 3, 6, 12, and 24 months after treatment initiation.
RESULTS: A total of 23 patients in the Tofa group (76.6%) and 24 patients in the ADA group (70.5%) achieved remission. Both groups exhibited improvements in mean best-corrected visual acuity (BCVA, Snellen chart, from baseline 0.33 ± 0.31 to 0.54 ± 0.27 in the ADA group, and from baseline 0.31 ± 0.27 to 0.57 ± 0.31 in the Tofa group), central macular thickness (CMT, from baseline 354.53 ± 101 μm to 199.71 ± 57 μm in the ADA group and from baseline 366.77 ± 120 μm to 203.67 ± 71 μm in the Tofa group), anterior chamber cell counts, and vitreous haze. No statistically significant differences were observed between the two groups in these overall outcomes. In an exploratory subgroup analysis, Tofa showed a lower response rate in patients with central occlusive retinal vasculitis, with 1/7 patients responding, whereas 6/8 patients responded in the ADA group (P = 0.041).
CONCLUSIONS: Both ADA and Tofa demonstrated favorable efficacy in treating refractory Behçet’s uveitis in this retrospective real-world study. The observed differences according to vasculitis phenotype should be interpreted cautiously and require confirmation in larger prospective studies.
PMID:42247158 | DOI:10.1007/s00417-026-07293-2
