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

  • Inflammatory Disorders
  • Published:
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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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Author notes

    Authors and Affiliations

    1. Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany

      Marc Breitbach, Christoph Tappeiner, Michael R. R. Böhm, Beatrix Zurek-Imhoff, Carsten Heinz & Arnd Heiligenhaus

    2. Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland

      Christoph Tappeiner

    3. Department of Ophthalmology, Clinic for Diseases of the Anterior Segments of the Eyes, Essen University Hospital, Essen, Germany

      Michael R. R. Böhm

    4. University of Duisburg-Essen, Essen, Germany

      Michael R. R. Böhm, Carsten Heinz & Arnd Heiligenhaus

    5. Institute of Experimental Ophthalmology, Westfaelische Wilhelms-University, Muenster, Germany

      Solon Thanos

    6. Department of Paediatric Rheumatology, St. Josef-Stift, Sendenhorst, Germany

      Gerd Ganser

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    1. Marc Breitbach
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    Correspondence to Arnd Heiligenhaus.

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    All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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    No funding was received for this research.

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    This study was conducted as a retrospective trial. For this type of study formal consent is not required.

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    Marc Breitbach and Christoph Tappeiner contributed equally to this work.

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    Breitbach, M., Tappeiner, C., Böhm, M.R.R. et al. Discontinuation of long-term adalimumab treatment in patients with juvenile idiopathic arthritis-associated uveitis. Graefes Arch Clin Exp Ophthalmol 255, 171–177 (2017). https://doi.org/10.1007/s00417-016-3497-5

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    • DOI: https://doi.org/10.1007/s00417-016-3497-5

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