Comparison of Infliximab with Adalimumab for the treatment of non- infectious uveitis: a systematic review and meta-analysis

Abstract

Abstract Purpose: To compare Infliximab and Adalimumab on the efficacy and safety for the treatment of non-infectious uveitis (NIU). Methods: We searched for relevant studies in the PubMed, Embase, ClinicalTrials.gov, Cochrane Library databases, with language restricted in English, China National Knowledge Infrastructure (CNKI), and Wan Fang databases up to September 2022. The incidences of complete inflammation remission, overall inflammation remission, adverse events and corticosteroid-sparing effects were evaluated. Results: Eleven clinical trials covering 1459 NIU patients were included. Complete inflammation remission after therapy was achieved in 161 (37.5%) patients in Infliximab group and 151 (39.6%) patients in Adalimumab group. These two groups had no significant difference (P = 0.37). Overall inflammation remission of anti-TNF drugs involved 449 patients, with 241/272 (88.6%) being treated with Infliximab and 153/177 (86.4%) being treated with Adalimumab. No significant difference was observed with regard to the overall inflammation remission between the two cohorts (P = 0.86). There were no significant differences between Infliximab and Adalimumab as far as corticosteroid-sparing effects (P = 0.58). Pooled effect size (P = 0.001) showed a statistically significant difference, with incidence of adverse events being 17.91% in Infliximab and 12.12% in Adalimumab. Conclusion: Our systematic review and meta-analysis of 11 studies suggests that Infliximab and Adalimumab offer similar therapeutic efficacy and corticosteroid-sparing effects for patients with NIU. But Adalimumab has a marginal advantage over Infliximab in terms of adverse events. Large-scale RCTs with a longer follow-up are required to further evaluate these two anti-TNF-α agents for NIU patients.