Discontinuation of long-term adalimumab treatment in patients with juvenile idiopathic arthritis-associated uveitis

Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):171-177. doi: 10.1007/s00417-016-3497-5. Epub 2016 Sep 30.

Abstract

Purpose: 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.

Keywords: Adalimumab; Biological disease-modifying anti-rheumatic drug; Juvenile idiopathic arthritis; Uveitis.

MeSH terms

  • Adalimumab / therapeutic use*
  • Adult
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / drug therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Registries*
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Uveitis, Anterior / drug therapy*
  • Uveitis, Anterior / etiology
  • Withholding Treatment*

Substances

  • Antirheumatic Agents
  • Adalimumab