#2-22E. Comparative Effectiveness for Behçet’s Uveitis Relapse Prevention (ACR, 2025)

In the management of Behçet’s disease uveitis, where recurrent inflammation poses a significant threat to vision, clinicians constantly face the challenge of determining the optimal long-term immunomodulatory therapy among available options. This study utilized real-world data and the target trial emulation method to comparatively evaluate the effectiveness of cyclosporine, interferon alfa-2a (IFN-α2a), and adalimumab for uveitis relapse prevention. The analysis revealed a clear hierarchy in efficacy: the estimated mean annualized relapse rates were 0.95 for cyclosporine, 0.52 for IFN-α2a, and 0.28 for adalimumab. The most crucial finding is that adalimumab was associated with the strongest reduction in the annualized uveitis relapse rate compared to both IFN-α2a and cyclosporine. This finding suggests that adalimumab should be considered a clinical priority, potentially extending its application beyond severe cases to a broader patient population. However, it is essential to critically note that, despite rigorous application of overlap weighting, this remains an observational study using target trial emulation, meaning the possibility of residual confounding by unmeasured variables still exists. This real-world evidence is highly valuable for physicians, providing data-driven guidance for optimizing long-term therapeutic strategies, especially when balancing clinical effectiveness against cost considerations for Behçet’s uveitis.

Citation: Zhong Z, Wang J, Xia L, Jing S, Lai Y, Cai T, Yang P. Comparative Real-World Effectiveness of Immunomodulatory Therapies for Prevention of Uveitis Relapse in Behçet’s Disease. ACR Journals. 2025. DOI: 10.1002/art.43382

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