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Neil Abi-Ayad, Pierre Quartier, Celine Terrada, Christine Fardeau, Nathalie Cassoux, Phuc Lehoang, Bahram Bodaghi; Adalimumab In Juvenile Idiopathic Arthritis-associated Uveitis : A Retrospective Monocentric Study Of 18 Children. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6566.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate adalimumab in severe juvenile idiopathic arthritis (JIA)-associated uveitis
We retrospectively analysed 18 children with severe JIA-associated uveitis, who were treated with adalimumab (20 or 40-mg, every two weeks) when the previous immunosuppressive therapy had been ineffective. It consisted of systemic steroids (n=18), methotrexate (n=18), azathioprine (n=8), mycophenolate mofetil (n=1), infliximab (n=5), etanercept (n=5). Primary outcome was to assess decreasing in laser flare photometry values 3 months after adalimumab therapy. Clinical features (Standardization of Uveitis Nomenclature criteria, vitreous haze, macular edema and papillitis) and oral prednisone threshold were also considered.
Median age was 5.7 years (range 1-16) and sex ratio (F/M) was 3.5. Median duration before adalimumab therapy was 82.6 months (range 16-262). Median laser flare photometry value at 3 months was significantly reduced from 149.5 ph/ms (range 24-335) to 71.5 ph/ms (range 8-164) (p<0.03). During a mean follow-up of 18.4 months (range 3-60), median oral prednisone decreased from 10 mg/day (range 0-20) to 5.25 mg/day (range 0-20). Uveitis was controlled in 13 cases (72.2%). Relapses occurred in two cases (11.1%) and adalimumab was ineffective in three cases (16.7%). Two children (11.1%) discontinued the treatment : one because of intolerance with allergic reaction, and one because of neurologic side-effects.
Adalimumab is efficient to control uveitis and seems to have a steroid-sparing effect. Laser flare photometry provides an objective improvement of intraocular inflammation at 3 months of treatment in most of severe cases.
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