title: Safety and efficacy of infliximab and adalimumab for refractory uveitis in juvenile idiopathic arthritis: 1-year followup data from the Italian Registry.
abstract: OBJECTIVE
  To evaluate safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of juvenile idiopathic arthritis-related anterior uveitis (JIA-AU).
  
  
  METHODS
  Starting January 2007, patients with JIA-AU treated with IFX and ADA were managed by a standard protocol and data were entered into the National Italian Registry (NIR). At baseline, all patients were refractory to standard immunosuppressive treatment and/or were corticosteroid-dependent. Data recorded every 3 months included uveitis course, number/type of ocular complications, drug-related adverse events (AE), treatment change or withdrawal, and laboratory measures. Data of patients treated for at least 1 year were retrieved from the NIR and analyzed using descriptive statistics. Treatment efficacy was based on change in uveitis course and in number of ocular complications.
  
  
  RESULTS
  Up to December 2009, data for 108 patients with JIA-AU treated with anti-tumor necrosis factor-α agents were recorded in the NIR and data from 91, with at least 12 months' followup, were included in the study. Forty-eight patients were treated with IFX, 43 with ADA. Forty-seven patients (55.3%) achieved remission of AU, 28 (32.9%) had recurrent AU, and 10 (11.8%) maintained a chronic course. A higher remission rate was observed with ADA (67.4% vs 42.8% with IFX; p = 0.025). Ocular complications decreased from 0.47 to 0.32 per subject. Five patients experienced resolution of structural complications. No patient reported serious AE; 8 (8.8%) experienced 11 minor AE (9 with IFX, 2 with ADA).
  
  
  CONCLUSIONS
  IFX and ADA appear to be effective and safe for treatment of refractory JIA-related uveitis, with a better performance of ADA in the medium-term period.
authors.affiliation: Department of Pediatrics, University of Padua, Padua, Italy. ezannin@pediatria.unipd.it
authors.forename: Maria E
authors.initials: ME
authors.lastname: Zannin
authors.forename: Carolina
authors.initials: C
authors.lastname: Birolo
authors.forename: Valeria M
authors.initials: VM
authors.lastname: Gerloni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Miserocchi
authors.forename: Irene
authors.initials: I
authors.lastname: Pontikaki
authors.forename: Maria P
authors.initials: MP
authors.lastname: Paroli
authors.forename: Claudia
authors.initials: C
authors.lastname: Bracaglia
authors.forename: Alison
authors.initials: A
authors.lastname: Shardlow
authors.forename: Fulvio
authors.initials: F
authors.lastname: Parentin
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simonini
authors.forename: Fernanda
authors.initials: F
authors.lastname: Falcini
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Corona
authors.forename: Stefania
authors.initials: S
authors.lastname: Viola
authors.forename: Riccardo
authors.initials: R
authors.lastname: De Marco
authors.forename: Luciana
authors.initials: L
authors.lastname: Breda
authors.forename: Francesco
authors.initials: F
authors.lastname: La Torre
authors.forename: Fabio
authors.initials: F
authors.lastname: Vittadello
authors.forename: Giorgia
authors.initials: G
authors.lastname: Martini
authors.forename: Francesco
authors.initials: F
authors.lastname: Zulian
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D000069285:Infliximab; D007558:Italy; D008297:Male; D012042:Registries; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab