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

Discontinuation of long-term adalimumab treatment in patients with juvenile idiopathic arthritis-associated uveitis.
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Breitbach M, Tappeiner C, Böhm MR, Zurek-Imhoff B, Heinz C, Thanos S, Ganser G, Heiligenhaus A,


Breitbach M, Tappeiner C, Böhm MR, Zurek-Imhoff B, Heinz C, Thanos S, Ganser G, Heiligenhaus A, (click to view)

Breitbach M, Tappeiner C, Böhm MR, Zurek-Imhoff B, Heinz C, Thanos S, Ganser G, Heiligenhaus A,

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Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 2016 9 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.

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