Adalimumab and dexamethasone for treating non-infectious uveitis

Adalimumab is recommended as an option for treating non-infectious uveitis in the posterior segment of the eye in adults with inadequate response to corticosteroids, only if there is:

• active disease (that is, current inflammation in the eye) and

• inadequate response or intolerance to immunosuppressants and

• systemic disease or both eyes are affected (or 1 eye is affected if the second eye has poor visual acuity) and

• worsening vision with a high risk of blindness (for example, risk of blindness that is similar to that seen in people with macular oedema).

Stop adalimumab for non-infectious uveitis in the posterior segment of the eye in adults with inadequate response to corticosteroids if there is 1 of the following:

• new active inflammatory chorioretinal or inflammatory retinal vascular lesions, or both or

• a 2‑step increase in vitreous haze or anterior chamber cell grade or

• worsening of best corrected visual acuity by 3 or more lines or 15 letters.

Dexamethasone intravitreal implant is recommended as an option for treating non-infectious uveitis in the posterior segment of the eye in adults, only if there is:

• active disease (that is, current inflammation in the eye) and

• worsening vision with a risk of blindness.

These recommendations are not intended to affect treatment with adalimumab and dexamethasone that was started in the NHS before this guidance was published. Adults having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.