SUMMARYA 70-year-old man, ex-smoker with a 3-pack-year smoking history, presented with a 5-week history of persistent cough. There were no positive findings on clinical examination. The patient's chest X-ray showed a nodular density in the right lung, initially thought to be malignant. After an extensive workup which included CT-guided lung biopsies, bronchoscopies, positron emission tomography scanning, among many other investigations, discussion at the respiratory multidisciplinary team meeting, and a right upper lobe lung resection, a diagnosis of histoplasmosis was performed.
BACKGROUND
Background
Adalimumab has demonstrated efficacy in non-infectious uveitis. With the introduction of biosimilar agents such as Amgevita, we aimed to quantify efficacy and tolerability compared to Humira in a multi-centre UK cohort
Methods
Patients identified from tertiary uveitis clinics in 3 centres, after institution-mandated switching was implemented.
Results
Data collected for 102 patients, aged 2–75 years, with 185 active eyes. Following switch, rates of uveitis flare were not significantly different (13 events before, 21 after,
p
= .132). Rates of elevated intraocular pressure were decreased (32 before, 25 afterwards,
p
= .006) and dosing of oral and intra-ocular steroids was stable. Twenty-four patients (24%) requested to return to Humira, commonly due to pain from injection or technical difficulty with the device.
Conclusion
Amgevita is safe and effective for inflammatory uveitis with non-inferiority to Humira. Significant numbers of patients requested to switch back due to side effects including injection site reactions.
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