Long-Term Effects of Adalimumab in Juvenile Idiopathic Arthritis-Associated Uveitis: 3- and 6-Year Results of the ADJUVITE Trial

Abstract

Purpose: To evaluate the long-term efficacy of and tolerance to adalimumab in patients with juvenile idiopathic arthritis-associated uveitis (JIA-U).

Methods: This retrospective study included patients with JIA-U who completed the ADJUVITE trial with at least 2 years and up to 5 years of follow-up after the end of the trial (i.e. at least 3 years and up to 6 years of follow-up after randomization). Data, including treatment course, visual and anatomical outcomes, uveitis activity evaluated by laser flare photometry, and safety were collected from medical records.

Results: Forty-one eyes of 25 participants with a mean age of 10.5 ± 4.0 years at the end of the trial were enrolled. Twenty-one patients (84%) responded to adalimumab during a mean follow-up period of 68.0 ± 21.6 months (range 26-109 months, post-trial), and among the responders, one patient could discontinue adalimumab without further uveitis relapse. Five years after the end of the trial, the mean BCVA improved to 0.07 ± 0.39 logMAR (vs. 0.14 ± 0.20 logMAR, p = 0.048) and the mean anterior chamber flare decreased to 29.9 ± 19.1 ph/ms (vs. 37.2 ± 35.0 ph/ms, p = 0.170). The mean dose of methotrexate decreased significantly from 11.3 ± 4.4 mg/week at the end of the trial to 5.2 ± 6.2 mg/week at the last follow-up (p = 0.002). Four patients did not respond to adalimumab and required other biologics. Adalimumab was well-tolerated in all patients.

Conclusions: Adalimumab was effective in maintaining long-term uveitis control in patients with JIA-U, with a good safety profile. However, complete discontinuation was not possible in most cases, confirming the suspending effect of adalimumab.

Keywords: Adalimumab; efficacy; juvenile idiopathic arthritis; tolerance; uveitis.