Efficacy of adalimumab in chronic non-infectious anterior uveitis: a retrospective study

Background To evaluate the clinical efficacy of adalimumab (ADA) in the treatment of chronic non-infectious anterior uveitis (NIAU). Methods This was a retrospective, single-center observational study. A total of 114 patients with chronic NIAU who were treated at Baoji People’s Hospital between May 2022 and May 2025 and had complete electronic medical records were included. The cohort comprised 45 males and 69 females, with a mean age of 42.15 ± 14.28 years (range, 7–86 years). Patients were divided into two groups according to whether ADA was administered. The control group (n = 56) received conventional therapy with topical corticosteroids and mydriatic/cycloplegic agents, while the study group (n = 58) received additional subcutaneous ADA on the basis of conventional treatment. Demographic characteristics, disease duration, Anterior chamber cell count(AC cell count), and best-corrected visual acuity (BCVA) were collected. AC cell count, BCVA, treatment efficacy, and recurrence rates were compared at baseline and at 1, 2, and 3 weeks, as well as 3 and 6 months after treatment. Statistical analyses were performed using independent-sample t-tests, Mann–Whitney U tests, and χ² tests, with P < 0.05 considered statistically significant. Results There were no significant differences between the two groups in age, baseline AC cell count, or baseline BCVA (all P > 0.05), while disease duration was longer in the study group (P = 0.017). Idiopathic NIAU was the most common etiology (58.62% in the study group and 69.64% in the control group), followed by ankylosing spondylitis, rheumatoid arthritis, juvenile idiopathic arthritis, and psoriatic arthritis. During the first 2 weeks of treatment, AC cell count decreased markedly in both groups, with no significant intergroup differences (all P > 0.05). From week 3 onward, AC cell count improvement was significantly greater in the study group than in the control group (all P < 0.05). BCVA improved in both groups during the first 3 weeks without significant differences; however, at 3 and 6 months, BCVA was significantly better in the study group (both P < 0.05). At 6 months, the study group demonstrated a higher complete remission rate (84.48% vs. 64.29%), a lower recurrence rate (13.79% vs. 28.57%), and a higher overall treatment efficacy (96.55% vs. 87.50%) compared with the control group (all P < 0.05). Conclusions Adalimumab appears to be an effective therapeutic option for recurrent chronic non-infectious anterior uveitis, particularly in patients with underlying autoimmune diseases. ADA can achieve better inflammation control, improve treatment efficacy, reduce recurrence, and decrease the need for corticosteroids and immunosuppressive therapy.