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

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

Author information

1
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany.
2
Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.
3
Department of Ophthalmology, Clinic for Diseases of the Anterior Segments of the Eyes, Essen University Hospital, Essen, Germany.
4
University of Duisburg-Essen, Essen, Germany.
5
Institute of Experimental Ophthalmology, Westfaelische Wilhelms-University, Muenster, Germany.
6
Department of Paediatric Rheumatology, St. Josef-Stift, Sendenhorst, Germany.
7
Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany. arnd.heiligenhaus@uveitis-zentrum.de.
8
University of Duisburg-Essen, Essen, Germany. arnd.heiligenhaus@uveitis-zentrum.de.

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

PMID:
27687987
DOI:
10.1007/s00417-016-3497-5
[Indexed for MEDLINE]

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