Discontinuation of long-term adalimumab treatment in patients with juvenile idiopathic arthritis-associated uveitis.
OBJECTIVE
The purpose of this study was to evaluate the discontinuation of adalimumab (ADA) treatment in patients with juvenile idiopathic arthritis-associated uveitis (JIAU).


METHODS
Patients in whom ADA treatment was initiated for JIAU were included in this retrospective analysis. Reasons for discontinuing ADA treatment in patients with primary treatment response were analysed.


RESULTS
Within a group of 387 JIAU patients, 59 of 68 patients who were treated with ADA achieved a sufficient response to treatment within 6 months. Here, 39 patients (66.1 %) were still on therapy at their last follow-up visit (mean treatment duration of 38.3 months, range 12-91). In another 20 patients, ADA had been discontinued after 1 or 2 years or later, in 10 % (n = 2), 45 % (n = 9) and 45 % (n = 9) of patients, respectively (mean 30.6 months; range 10-65). Reasons for discontinuing ADA were reactivation of uveitis (n = 8, 3.93 per 100 patient-years) or arthritis (n = 4; 1.97 per 100 patient-years), or ≥2 years of complete disease inactivity (n = 3, 1.47 per 100 patient-years), adverse events (n = 4; 1.89 per 100 patient-years), or other (n = 1; 0.47 per 100 patient-years).


CONCLUSIONS
The data show a good primary response to ADA in patients with refractory JIAU. Due to the increasing rate of adalimumab failure or adverse events during long-term treatment, further treatment options may be required.
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.
Marc
M
Breitbach
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.|Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.
Christoph
C
Tappeiner
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.|Department of Ophthalmology, Clinic for Diseases of the Anterior Segments of the Eyes, Essen University Hospital, Essen, Germany.|University of Duisburg-Essen, Essen, Germany.
Michael R R
MR
Böhm
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.
Beatrix
B
Zurek-Imhoff
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.|University of Duisburg-Essen, Essen, Germany.
Carsten
C
Heinz
Institute of Experimental Ophthalmology, Westfaelische Wilhelms-University, Muenster, Germany.
Solon
S
Thanos
Department of Paediatric Rheumatology, St. Josef-Stift, Sendenhorst, Germany.
Gerd
G
Ganser
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany. arnd.heiligenhaus@uveitis-zentrum.de.|University of Duisburg-Essen, Essen, Germany. arnd.heiligenhaus@uveitis-zentrum.de.
Arnd
A
Heiligenhaus
D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000188:drug therapy* / Q000209:etiology; D028761:Withholding Treatment
D018501:Antirheumatic Agents; D000068879:Adalimumab
Adalimumab; Biological disease-modifying anti-rheumatic drug; Juvenile idiopathic arthritis; Uveitis
Ophthalmology. 2001 Nov;108(11):2071-5
11713082
Br J Ophthalmol. 2002 Jan;86(1):51-6
11801504
Ophthalmology. 2006 May;113(5):853-9.e2
16650683
Am J Ophthalmol. 2005 Sep;140(3):509-16
16196117
Rheumatology (Oxford). 2007 Jun;46(6):1015-9
17403710
J Pediatr. 2006 Oct;149(4):572-5
17011337
Am J Ophthalmol. 2003 May;135(5):676-80
12719076
Arthritis Care Res (Hoboken). 2014 Jul;66(7):1073-84
24740981
J Rheumatol. 2007 May;34(5):1146-50
17343318
Arthritis Care Res (Hoboken). 2012 Sep;64(9):1365-72
22438273
Am J Ophthalmol. 2015 Jul;160(1):193-200.e1
25892124
Rheumatol Int. 2012 May;32(5):1121-33
22083610
Ophthalmology. 2013 Jan;120(1):186-92
23062650
Clin Ophthalmol. 2011;5:1425-9
22034564
Br J Ophthalmol. 2007 Mar;91(3):319-24
17035274
Br J Ophthalmol. 2005 Apr;89(4):444-8
15774921
Arthritis Rheumatol. 2014 Sep;66(9):2580-9
24942886
Mediators Inflamm. 2013;2013:560632
24489444
J Rheumatol. 2004 Feb;31(2):390-2
14760812
Rheumatology (Oxford). 2015 Jul;54(7):1170-6
25504896
Ann Rheum Dis. 1998 Jan;57(1):38-41
9536821
Arthritis Care Res (Hoboken). 2015 Nov;67(11):1529-35
25988824
Rheumatology (Oxford). 2008 Mar;47(3):339-44
18238789
Rheumatol Int. 2015 May;35(5):777-85
25656443
J Rheumatol. 2013 Jan;40(1):74-9
23118110
Ocul Immunol Inflamm. 2015 Feb;23(1):67-73
24410459
Arthritis Care Res (Hoboken). 2011 Apr;63(4):612-8
21452272
Pediatr Rheumatol Online J. 2013 Apr 15;11:16
23587261
Ocul Immunol Inflamm. 2013 Jun;21(3):180-91
23713827
Graefes Arch Clin Exp Ophthalmol. 2013 Jun;251(6):1601-6
23446556
Br J Ophthalmol. 2014 Apr;98(4):523-8
24457365
Am J Ophthalmol. 2007 May;143(5):840-846
17362866
Graefes Arch Clin Exp Ophthalmol. 2006 Mar;244(3):281-90
16228217