Longterm Safety and Efficacy of Adalimumab and Infliximab for Uveitis Associated with Juvenile Idiopathic Arthritis

Vanessa Cecchin^{1

2}, Maria Elisabetta Zannin^{1

2}, Daniele Ferrari^{1

2}, Irene Pontikaki^{1

2}, Elisabetta Miserocchi^{1

2}, Maria P Paroli^{1

2}, Claudia Bracaglia^{1

2}, Denise Pires Marafon^{1

2}, Serena Pastore^{1

2}, Fulvio Parentin^{1

2}, Gabriele Simonini^{1

2}, Cinzia De Libero^{1

2}, Fernanda Falcini^{1

2}, Antonella Petaccia^{1

2}, Giovanni Filocamo^{1

2}, Riccardo De Marco^{1

2}, Francesco La Torre^{1

2}, Silvana Guerriero^{1

2}, Silvana Martino^{1

2}, Francesco Comacchio^{1

2}, Valentina Muratore^{1

2}, Giorgia Martini^{1

2}, Fabio Vittadello^{1

2}, Francesco Zulian^{3

4}

Affiliations

¹ From the Department of Woman and Child Health, University of Padua, Padua; G. Pini Institute for Rheumatology; Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda, Ospedale Maggiore Policlinico, Milan; Department of Ophthalmology, Sapienza University; Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome; Institute for Maternal and Child Health IRCCS "Burlo Garofolo," Trieste; Anna Meyer Children's Hospital, and Department of Internal Medicine, Rheumatology, Transition Clinic, University of Florence, Florence; G. Gaslini Children's Hospital, Genoa; Department of Pediatrics, A. Perrino Hospital, Brindisi; Department of Neurosciences and Sense Organs, University of Bari, Bari; Ospedale Infantile Regina Margherita, University of Torino, Torino; Ophthalmology Unit, University Hospital Borgo Trento, Verona; IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
² V. Cecchin, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; M.E. Zannin, MD, Department of Woman and Child Health, University of Padua; D. Ferrari, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; I. Pontikaki, MD, Assistant Professor, G. Pini Institute for Rheumatology, Milan; E. Miserocchi, MD, Assistant Professor, G. Pini Institute for Rheumatology; M.P. Paroli, MD, Assistant Professor, Department of Ophthalmology, Sapienza University; C. Bracaglia, MD, Assistant Professor, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; D.P. Marafon, MD, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; S. Pastore, MD, Rheumatology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; F. Parentin, MD, Assistant Professor, Ophthalmology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; G. Simonini, MD, Associate Professor, Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence; C. De Libero, MD, Ophthalmology Unit, Anna Meyer Children's Hospital, University of Florence; F. Falcini, MD, Associate Professor, Rheumatology Unit, Transition Clinic, University of Florence; A. Petaccia, MD, Assistant Professor, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico; G. Filocamo, MD, Assistant Professor, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico; R. De Marco, MD, Assistant Professor, Ophthalmology Unit, G. Gaslini Children's Hospital; F. La Torre, MD, Assistant Professor, Department of Pediatrics, A. Perrino Hospital; S. Guerriero, MD, Associate Professor, Department of Neurosciences and Sense Organs, University of Bari; S. Martino, MD, Associate Professor, Ospedale Infantile Regina Margherita, University of Torino; F. Comacchio, MD, Assistant Professor, Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Verona University Medical School, and University Hospital Borgo Trento; V. Muratore, MD, Assistant Professor, Department of Pediatrics, IRCCS Fondazione Policlinico San Matteo; G. Martini, MD, PhD, Assistant Professor, Department of Woman and Child Health, University of Padua; F. Vittadello, Department of Woman and Child Health, University of Padua; F. Zulian, MD, Associate Professor, Rheumatology Unit, Department of Woman and Child Health, University of Padua.
³ From the Department of Woman and Child Health, University of Padua, Padua; G. Pini Institute for Rheumatology; Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda, Ospedale Maggiore Policlinico, Milan; Department of Ophthalmology, Sapienza University; Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome; Institute for Maternal and Child Health IRCCS "Burlo Garofolo," Trieste; Anna Meyer Children's Hospital, and Department of Internal Medicine, Rheumatology, Transition Clinic, University of Florence, Florence; G. Gaslini Children's Hospital, Genoa; Department of Pediatrics, A. Perrino Hospital, Brindisi; Department of Neurosciences and Sense Organs, University of Bari, Bari; Ospedale Infantile Regina Margherita, University of Torino, Torino; Ophthalmology Unit, University Hospital Borgo Trento, Verona; IRCCS Fondazione Policlinico San Matteo, Pavia, Italy. francescozulian58@gmail.com.
⁴ V. Cecchin, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; M.E. Zannin, MD, Department of Woman and Child Health, University of Padua; D. Ferrari, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; I. Pontikaki, MD, Assistant Professor, G. Pini Institute for Rheumatology, Milan; E. Miserocchi, MD, Assistant Professor, G. Pini Institute for Rheumatology; M.P. Paroli, MD, Assistant Professor, Department of Ophthalmology, Sapienza University; C. Bracaglia, MD, Assistant Professor, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; D.P. Marafon, MD, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; S. Pastore, MD, Rheumatology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; F. Parentin, MD, Assistant Professor, Ophthalmology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; G. Simonini, MD, Associate Professor, Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence; C. De Libero, MD, Ophthalmology Unit, Anna Meyer Children's Hospital, University of Florence; F. Falcini, MD, Associate Professor, Rheumatology Unit, Transition Clinic, University of Florence; A. Petaccia, MD, Assistant Professor, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico; G. Filocamo, MD, Assistant Professor, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico; R. De Marco, MD, Assistant Professor, Ophthalmology Unit, G. Gaslini Children's Hospital; F. La Torre, MD, Assistant Professor, Department of Pediatrics, A. Perrino Hospital; S. Guerriero, MD, Associate Professor, Department of Neurosciences and Sense Organs, University of Bari; S. Martino, MD, Associate Professor, Ospedale Infantile Regina Margherita, University of Torino; F. Comacchio, MD, Assistant Professor, Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Verona University Medical School, and University Hospital Borgo Trento; V. Muratore, MD, Assistant Professor, Department of Pediatrics, IRCCS Fondazione Policlinico San Matteo; G. Martini, MD, PhD, Assistant Professor, Department of Woman and Child Health, University of Padua; F. Vittadello, Department of Woman and Child Health, University of Padua; F. Zulian, MD, Associate Professor, Rheumatology Unit, Department of Woman and Child Health, University of Padua. francescozulian58@gmail.com.

PMID: 29657140
DOI: 10.3899/jrheum.171006

Free article

Longterm Safety and Efficacy of Adalimumab and Infliximab for Uveitis Associated with Juvenile Idiopathic Arthritis

Vanessa Cecchin et al. J Rheumatol. 2018 Aug.

Free article

. 2018 Aug;45(8):1167-1172.

doi: 10.3899/jrheum.171006. Epub 2018 Apr 15.

Authors

Affiliations

¹ From the Department of Woman and Child Health, University of Padua, Padua; G. Pini Institute for Rheumatology; Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda, Ospedale Maggiore Policlinico, Milan; Department of Ophthalmology, Sapienza University; Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome; Institute for Maternal and Child Health IRCCS "Burlo Garofolo," Trieste; Anna Meyer Children's Hospital, and Department of Internal Medicine, Rheumatology, Transition Clinic, University of Florence, Florence; G. Gaslini Children's Hospital, Genoa; Department of Pediatrics, A. Perrino Hospital, Brindisi; Department of Neurosciences and Sense Organs, University of Bari, Bari; Ospedale Infantile Regina Margherita, University of Torino, Torino; Ophthalmology Unit, University Hospital Borgo Trento, Verona; IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
² V. Cecchin, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; M.E. Zannin, MD, Department of Woman and Child Health, University of Padua; D. Ferrari, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; I. Pontikaki, MD, Assistant Professor, G. Pini Institute for Rheumatology, Milan; E. Miserocchi, MD, Assistant Professor, G. Pini Institute for Rheumatology; M.P. Paroli, MD, Assistant Professor, Department of Ophthalmology, Sapienza University; C. Bracaglia, MD, Assistant Professor, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; D.P. Marafon, MD, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; S. Pastore, MD, Rheumatology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; F. Parentin, MD, Assistant Professor, Ophthalmology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; G. Simonini, MD, Associate Professor, Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence; C. De Libero, MD, Ophthalmology Unit, Anna Meyer Children's Hospital, University of Florence; F. Falcini, MD, Associate Professor, Rheumatology Unit, Transition Clinic, University of Florence; A. Petaccia, MD, Assistant Professor, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico; G. Filocamo, MD, Assistant Professor, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico; R. De Marco, MD, Assistant Professor, Ophthalmology Unit, G. Gaslini Children's Hospital; F. La Torre, MD, Assistant Professor, Department of Pediatrics, A. Perrino Hospital; S. Guerriero, MD, Associate Professor, Department of Neurosciences and Sense Organs, University of Bari; S. Martino, MD, Associate Professor, Ospedale Infantile Regina Margherita, University of Torino; F. Comacchio, MD, Assistant Professor, Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Verona University Medical School, and University Hospital Borgo Trento; V. Muratore, MD, Assistant Professor, Department of Pediatrics, IRCCS Fondazione Policlinico San Matteo; G. Martini, MD, PhD, Assistant Professor, Department of Woman and Child Health, University of Padua; F. Vittadello, Department of Woman and Child Health, University of Padua; F. Zulian, MD, Associate Professor, Rheumatology Unit, Department of Woman and Child Health, University of Padua.
³ From the Department of Woman and Child Health, University of Padua, Padua; G. Pini Institute for Rheumatology; Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda, Ospedale Maggiore Policlinico, Milan; Department of Ophthalmology, Sapienza University; Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome; Institute for Maternal and Child Health IRCCS "Burlo Garofolo," Trieste; Anna Meyer Children's Hospital, and Department of Internal Medicine, Rheumatology, Transition Clinic, University of Florence, Florence; G. Gaslini Children's Hospital, Genoa; Department of Pediatrics, A. Perrino Hospital, Brindisi; Department of Neurosciences and Sense Organs, University of Bari, Bari; Ospedale Infantile Regina Margherita, University of Torino, Torino; Ophthalmology Unit, University Hospital Borgo Trento, Verona; IRCCS Fondazione Policlinico San Matteo, Pavia, Italy. francescozulian58@gmail.com.
⁴ V. Cecchin, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; M.E. Zannin, MD, Department of Woman and Child Health, University of Padua; D. Ferrari, MD, Assistant Professor, Department of Woman and Child Health, University of Padua; I. Pontikaki, MD, Assistant Professor, G. Pini Institute for Rheumatology, Milan; E. Miserocchi, MD, Assistant Professor, G. Pini Institute for Rheumatology; M.P. Paroli, MD, Assistant Professor, Department of Ophthalmology, Sapienza University; C. Bracaglia, MD, Assistant Professor, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; D.P. Marafon, MD, Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù; S. Pastore, MD, Rheumatology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; F. Parentin, MD, Assistant Professor, Ophthalmology Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo"; G. Simonini, MD, Associate Professor, Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence; C. De Libero, MD, Ophthalmology Unit, Anna Meyer Children's Hospital, University of Florence; F. Falcini, MD, Associate Professor, Rheumatology Unit, Transition Clinic, University of Florence; A. Petaccia, MD, Assistant Professor, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico; G. Filocamo, MD, Assistant Professor, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico; R. De Marco, MD, Assistant Professor, Ophthalmology Unit, G. Gaslini Children's Hospital; F. La Torre, MD, Assistant Professor, Department of Pediatrics, A. Perrino Hospital; S. Guerriero, MD, Associate Professor, Department of Neurosciences and Sense Organs, University of Bari; S. Martino, MD, Associate Professor, Ospedale Infantile Regina Margherita, University of Torino; F. Comacchio, MD, Assistant Professor, Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Verona University Medical School, and University Hospital Borgo Trento; V. Muratore, MD, Assistant Professor, Department of Pediatrics, IRCCS Fondazione Policlinico San Matteo; G. Martini, MD, PhD, Assistant Professor, Department of Woman and Child Health, University of Padua; F. Vittadello, Department of Woman and Child Health, University of Padua; F. Zulian, MD, Associate Professor, Rheumatology Unit, Department of Woman and Child Health, University of Padua. francescozulian58@gmail.com.

PMID: 29657140
DOI: 10.3899/jrheum.171006

Abstract

Objective: Anti-TNF-α agents have significantly changed the management of juvenile idiopathic arthritis (JIA). We evaluated the safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of JIA-associated uveitis in patients treated for ≥ 2 years.

Methods: Patients with JIA-associated uveitis treated with IFX and ADA were managed by a standardized protocol and data were entered in the ORCHIDEA registry. At baseline, all patients were refractory to standard immunosuppressive treatment or were corticosteroid-dependent. Data recorded every 3 months were uveitis course, number/type of ocular flares and complications, drug-related adverse events (AE), and treatment switch or withdrawal. Data of patients treated for ≥ 2 years were analyzed by descriptive statistics.

Results: Up to December 2014, 154 patients with ≥ 24 months followup were included in the study. Fifty-nine patients were treated with IFX and 95 with ADA. Clinical remission, defined as the absence of flares for > 6 months on treatment, was achieved in 69 patients (44.8%), with a better remission rate for ADA (60.0%) as compared to IFX (20.3%; p < 0.001). A significant reduction of flares was observed in all patients without difference between the 2 treatment modalities. The number of new ocular complications decreased in both groups but was lower for ADA (p = 0.015). No serious AE were recorded; 16.4% of patients experienced 35 minor AE and the incidence rate was lower with ADA than with IFX.

Conclusion: At the 2-year followup, ADA showed a better efficacy and safety profile than IFX for the treatment of refractory JIA-associated uveitis.

Keywords: ANTI-TNF AGENTS; JUVENILE IDIOPATHIC ARTHRITIS; TREATMENT; UVEITIS.

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Longterm Safety and Efficacy of Adalimumab and Infliximab for Uveitis Associated with Juvenile Idiopathic Arthritis

Affiliations

Longterm Safety and Efficacy of Adalimumab and Infliximab for Uveitis Associated with Juvenile Idiopathic Arthritis

Authors

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Abstract

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