Comparative effectiveness of combination therapy of adalimumab and glucocorticoid with glucocorticoid monotherapy in Vogt–Koyanagi–Harada disease

Purpose: To make a preliminary investigation of the clinical efficacy and safety in treating VKH between adalimumab combined with glucocorticoids and adalimumab alone. Methods: The medical records of 23 patients with VKH diagnosed were retrospectively analyzed, the GM group received glucocorticoid monotherapy, and the ACWG group received a consolidation of adalimumab subcutaneous injection on top of the conventional treatment in the GM group. The BCVA, and the CMT, as well as the oral hormone dose, recurrence,and adverse events were investigated. Results: 23 patients (46 eyes) with VKH syndrome were included in this study, 11 males and 12 females. After 3,6 and 10 months of the treatment, the ACWG group significantly improved BCVA compared to the GM group ( P <0.05). Compared to pre-treatment, CMT decreased at all time points after treatment in both groups ( P <0.05). There was a statistically significant difference in CMT improvement between the two groups after 1 month and 3 months of treatment ( P ＜0.05). The average steroid dose was reduced significantly in the ACWG group( P ＜0.05). A higher recurrence rate was found in the GM group( P =0.046). Conclusion: The therapy of adalimumab combined with a glucocorticoid is effective and safe, and the recurrence and the burden of oral hormones are also reduced.