Usefulness of adalimumab in the treatment of refractory uveitis associated with juvenile idiopathic arthritis.
OBJECTIVE
To assess the efficacy and safety of adalimumab in patients with juvenile idiopathic arthritis (JIA) and associated refractory uveitis.


METHODS
Multicenter, prospective case series.


METHODS
Thirty-nine patients (mean [SD] age of 11.5 [7.9] years) with JIA-associated uveitis who were either not responsive to standard immunosuppressive therapy or intolerant to it were enrolled. Patients aged 13-17 years were treated with 40 mg of adalimumab every other week for 6 months and those aged 4-12 years received 24 mg/m(2) body surface.


RESULTS
Inflammation of the anterior chamber (2.02 [1.16] versus 0.42 [0.62]) and of the posterior segment (2.38 [2.97] versus 0.35 [0.71] decreased significantly between baseline and the final visit (P < 0.001). The mean (SD) macular thickness at baseline was 304.54 (125.03)  μ and at the end of follow-up was 230.87 (31.12)  μ (P < 0.014). Baseline immunosuppression load was 8.10 (3.99) as compared with 5.08 (3.76) at the final visit (P < 0.001). The mean dose of corticosteroids also decreased from 0.25 (0.43) to 0 (0.02) mg (P < 0.001). No significant side effects requiring discontinuation of therapy were observed.


CONCLUSIONS
Adalimumab seems to be an effective and safe treatment for JIA-associated refractory uveitis and may reduce steroid requirement.
Ophthalmology Department, Hospital Sant Joan de Déu, Universidad de Barcelona, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, 08950 Barcelona, Spain.
Carmen
C
García-De-Vicuña
Service of Ophthalmology, Hospital Universitari i Politècnic La Fe, and Facultad de Medicina, Universidad de Valencia, Valencia, Spain.
Manuel
M
Díaz-Llopis
Service of Ophthalmology, Hospital Universitari i Politècnic La Fe, and Facultad de Medicina, Universidad de Valencia, Valencia, Spain.
David
D
Salom
Unit of Pediatric Rheumatology, Pediatrics Department, Hospital Sant Joan de Déu, Universidad de Barcelona, Esplugues del Llobregat, Barcelona, Spain.
Rosa
R
Bou
Ophthalmology Department, Hospital Sant Joan de Déu, Universidad de Barcelona, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, 08950 Barcelona, Spain.
Jesus
J
Díaz-Cascajosa
Service of Ophthalmology, Hospital de León, León, Spain.
Miguel
M
Cordero-Coma
Laboratory of Ocular Immunology and Uveitis, Instituto Nacional de Rehabilitación, Calzada Mexico-Xochimilco, Mexico, DF, Mexico.
Gabriela
G
Ortega
Service of Internal Medicine, Hospital San Cecilio, Granada, Spain.
Norberto
N
Ortego-Centeno
Service of Ophthalmology, Hospital Ramón y Cajal, Madrid, Spain.
Marta
M
Suarez-De-Figueroa
Service of Rheumatology, Hospital de Pontevedra, Pontevedra, Spain.
Juan
J
Cruz-Martínez
Service of Ophthalmology, Hospital de Cruces, Bilbao, Spain.
Alex
A
Fonollosa
Service of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Ricardo
R
Blanco
Service of Rheumatology, Hospital Virgen de la Salud, Toledo, Spain.
Ángel María
ÁM
García-Aparicio
Service of Ophthalmology, Hospital Clínico San Carlos, Madrid, Spain.
Jose M
JM
Benítez-Del-Castillo
Unit of Pediatric Rheumatology, Pediatrics Department, Hospital Sant Joan de Déu, Universidad de Barcelona, Esplugues del Llobregat, Barcelona, Spain.
Jordi
J
Antón
D000068879:Adalimumab; D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D008297:Male; D061214:Patient Safety; D011446:Prospective Studies; D013256:Steroids / Q000737:chemistry / Q000627:therapeutic use; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications / Q000188:drug therapy*
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D000068879:Adalimumab