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Am J Ophthalmol. 2019 Jun 12. pii: S0002-9394(19)30274-0. doi: 10.1016/j.ajo.2019.06.007. [Epub ahead of print]

Adalimumab in juvenile-idiopathic arthritis-associated uveitis (JIA-U): 5-year follow-up of the Bristol participants of the SYCAMORE trial.

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Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, UK.
Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK; University of Bristol, Bristol, UK; National Institute of Health Research and Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
University of Bristol, Bristol, UK; Department of Paediatric Rheumatology, University Hospital Bristol NHS Foundation Trust, Bristol, UK. Electronic address:



To determine longer-term outcomes of participants enrolled from a single center in the SYCAMORE trial, a randomized placebo-controlled trial of adalimumab versus placebo in children with juvenile idiopathic arthritis-associated uveitis (JIA-U) uncontrolled on methotrexate.


Retrospective interventional case series.


Medical records of all 28 SYCAMORE participants recruited at the Bristol Eye Hospital were reviewed at approximately 3-monthly intervals up to 5 years from the trial randomization date. Uveitis activity, treatment course, visual outcomes, ocular complications and adverse events were recorded. Data are presented using summary statistics.


Following withdrawal of the investigational medicinal product (IMP), 25 of the 28 participants were started on adalimumab for active juvenile idiopathic arthritis-associated uveitis (JIA-U). Of the 12 participants in the active treatment arm of the SYCAMORE study, 11 (92%) were restarted on adalimumab after withdrawal of the IMP for active JIA-U (median time to flare 188 days (range 42-413)). Two participants stopped adalimumab for uncontrolled JIA-U. One participant had a reduction in vision to 0.3 due to cataract. Mean visual acuity for the remaining 27 participants was -0.04 (right eye) and -0.05 (left eye).


Drug-induced remission of JIA-U did not persist when adalimumab was withdrawn after 1-2 years treatment. Adalimumab was well tolerated and visual acuity outcomes were excellent.


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