title: Prevention of flare recurrences in childhood-refractory chronic uveitis: an open-label comparative study of adalimumab versus infliximab.
abstract: OBJECTIVE
  To compare the efficacy and safety of adalimumab versus infliximab in an open-label prospective, comparative, multicenter cohort study of childhood noninfectious chronic uveitis.
  
  
  METHODS
  Thirty-three patients (22 females, 11 males, median age 9.17 years) with refractory, vision-threatening, noninfectious active uveitis were enrolled, and received for at least 1 year infliximab (5 mg/kg at weeks 0, 2, and 6, and then every 6-8 weeks) or adalimumab (24 mg/m2 every 2 weeks). The primary outcome was to assess, once remission was achieved, the time of a first relapse. Time to remission, time to steroid discontinuation, and the number of relapses were also considered.
  
  
  RESULTS
  Sixteen children (12 with juvenile idiopathic arthritis [JIA], 3 with idiopathic uveitis, and 1 with Behçet's disease) were recruited in the adalimumab cohort and 17 children (10 with JIA, 5 with idiopathic uveitis, 1 with early-onset sarcoidosis, and 1 with Behçet's disease) were recruited in the infliximab group. Cox regression analysis did not show statistically significant differences between the two groups with regard to time to achieve remission and time to steroid discontinuation, whereas a higher probability of uveitis remission on adalimumab during the time of treatment was shown (Mantel-Cox χ2=6.83, P<0.001). At 40 months of followup, 9 (60%) of 15 children receiving adalimumab compared to 3 (18.8%) of 16 children receiving infliximab were still in remission on therapy (P<0.02).
  
  
  CONCLUSIONS
  Even if limited to a relatively small group, our study suggests that over 3 years of treatment, adalimumab is more efficacious than infliximab in maintaining remission of chronic childhood uveitis.
authors: Rheumatology Unit, Anna Meyer Children's Hospital and Department of Paediatrics, University of Florence, Florence, Italy. gabriele.simonini@unifi.it
authors: Gabriele
authors: G
authors: Simonini
authors: Andrea
authors: A
authors: Taddio
authors: Marco
authors: M
authors: Cattalini
authors: Roberto
authors: R
authors: Caputo
authors: Cinzia
authors: C
authors: De Libero
authors: Samuele
authors: S
authors: Naviglio
authors: Cecilia
authors: C
authors: Bresci
authors: Monica
authors: M
authors: Lorusso
authors: Loredana
authors: L
authors: Lepore
authors: Rolando
authors: R
authors: Cimaz
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D011446:Prospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069285:Infliximab; D000068879:Adalimumab