Humira (adalimumab) is a medication used to manage uveitis, an inflammatory condition affecting the eye. This article explains what uveitis is, how Humira works, and what to expect during treatment.
Understanding Uveitis
Uveitis refers to inflammation of the uvea, the middle layer of the eye. The uvea is composed of the iris, which gives the eye its color, the ciliary body, a small muscle behind the iris, and the choroid, a layer of tissue located between the retina and the sclera. When the uvea becomes inflamed, it can damage surrounding eye tissue and potentially lead to permanent vision loss if left untreated.
There are different types of uveitis. Anterior uveitis, also known as iritis, affects the front of the eye, including the iris or ciliary body, and is the most common form. Intermediate uveitis involves inflammation of the ciliary body, the front end of the retina, and the jelly-like vitreous. Posterior uveitis is inflammation of the choroid, extending to the retina and optic nerve at the back of the eye. Panuveitis is the most comprehensive form, where inflammation affects all layers of the uvea: the iris, ciliary body, and choroid.
The causes of uveitis can vary, and sometimes the origin remains unknown. Common causes include autoimmune conditions, infections such as shingles, herpes simplex, syphilis, Lyme disease, and toxoplasmosis, or physical trauma to the eye. Symptoms can appear suddenly or develop gradually, and may include eye pain, redness, sensitivity to light (photophobia), blurred or cloudy vision, and “floaters” or specks in the field of vision. Prompt diagnosis by an ophthalmologist is important, as untreated uveitis can lead to complications such as glaucoma, cataracts, and retinal detachment.
How Humira Works for Uveitis
Humira, with the active ingredient adalimumab, is a biologic medication. It functions as a tumor necrosis factor-alpha (TNF-alpha) inhibitor. TNF-alpha is a protein produced by the body, and it plays a role in inflammatory responses. In conditions like uveitis, an excess of TNF-alpha contributes to the inflammation and damage within the eye.
Humira works by binding to TNF-alpha, preventing it from interacting with cell receptors. By blocking TNF-alpha, Humira effectively reduces the inflammatory cascade in the eye, helping to control uveitis, alleviate symptoms, and prevent further damage to ocular tissues.
Humira is administered through a subcutaneous injection. For adult patients with uveitis, the recommended initial dose is 80 mg, followed by 40 mg given every other week starting one week after the initial dose. For pediatric patients, dosing varies by weight and age. This medication is considered when conventional treatments, such as corticosteroids, are not sufficient to control the inflammation or when they cause unacceptable side effects.
What to Expect with Humira Treatment
Patients undergoing Humira treatment for uveitis can anticipate a reduction in inflammation within the eye. Clinical studies show Humira can increase the time non-infectious uveitis is controlled, reducing disease flares and maintaining visual clarity. Some patients may experience improved visual acuity and fewer symptoms such as vitreous haze or inflammatory cells in the front of the eye. Disease control has been observed as early as 6 weeks into treatment.
Common potential side effects associated with Humira include reactions at the injection site, such as pain, redness, rash, swelling, itching, or bruising. Patients may also experience upper respiratory infections, headaches, rash, or nausea. There is an increased risk of serious infections, including tuberculosis, and patients are screened for tuberculosis before starting treatment.
Less common but more serious risks include neurological problems or certain types of cancer. It is important to discuss all potential risks with a healthcare provider. Regular medical monitoring and follow-up appointments are a necessary part of Humira treatment. This involves blood tests to monitor for potential adverse effects and regular eye examinations to assess the level of inflammation and overall eye health.
Humira is generally considered a long-term management tool for uveitis rather than a cure. Individual responses to the medication can vary, and while some patients may achieve long-term remission, others may experience intermittent flares requiring ongoing adjustment of their treatment plan. The goal of treatment is to control inflammation, prevent vision loss, and improve the patient’s quality of life.