Adalimumab in juvenile idiopathic arthritis-associated chronic anterior uveitis.
OBJECTIVE
To evaluate the efficacy of adalimumab in juvenile idiopathic arthritis (JIA)-associated uveitis.


METHODS
Retrospective observational study of 20 patients with JIA and chronic uveitis on adalimumab treatment. The ocular inflammation and improvement was assessed according to the Standardization of Uveitis Nomenclature criteria.


RESULTS
At the initiation of adalimumab, the mean age of patients was 13.4 yrs and the mean duration of uveitis 8.7 yrs. Seventeen (85%) patients had polyarticular JIA and 19 (95%) had previously been on anti-TNF treatment. The mean duration of adalimumab therapy was 18.7 months. Of the 20 patients, 7 (35%) showed improved activity, 1 (5%) worsening activity and in 12 (60%) no change was observed in the activity of uveitis. Those with improved activity were younger and had shorter disease duration. The mean number of flares/yr decreased from 1.9 to 1.4 during adalimumab treatment. Serious adverse events or side-effects were not observed. Seven patients discontinued adalimumab during the follow-up: six because of inefficacy and one because of inactive uveitis.


CONCLUSIONS
Adalimumab is a potential treatment option in JIA-associated uveitis, even in patients non-responsive to previous other anti-TNF therapy.
Tynjälä
P
P
Department of Pediatric Rheumatology, Hospital for Children and Adolescents, Helsinki, Finland. pirjo.tynjala@hus.fi
Kotaniemi
K
K
Lindahl
P
P
Latva
K
K
Aalto
K
K
Honkanen
V
V
Lahdenne
P
P
D000068879:Adalimumab; D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D001171:Arthritis, Juvenile / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002908:Chronic Disease; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068879:Adalimumab