TY - JOUR T1 - Safety and efficacy of infliximab and adalimumab for refractory uveitis in juvenile idiopathic arthritis: 1-year followup data from the Italian Registry. JF - J Rheumatol Y1 - 2013 A1 - Zannin, Maria E A1 - Birolo, Carolina A1 - Gerloni, Valeria M A1 - Miserocchi, Elisabetta A1 - Pontikaki, Irene A1 - Paroli, Maria P A1 - Bracaglia, Claudia A1 - Shardlow, Alison A1 - Parentin, Fulvio A1 - Cimaz, Rolando A1 - Simonini, Gabriele A1 - Falcini, Fernanda A1 - Corona, Fabrizia A1 - Viola, Stefania A1 - De Marco, Riccardo A1 - Breda, Luciana A1 - La Torre, Francesco A1 - Vittadello, Fabio A1 - Martini, Giorgia A1 - Zulian, Francesco KW - Adolescent KW - Antibodies, Monoclonal KW - Antibodies, Monoclonal, Humanized KW - Antirheumatic Agents KW - Arthritis, Juvenile KW - Child KW - Child, Preschool KW - Female KW - Follow-Up Studies KW - Humans KW - Infant KW - Italy KW - Male KW - Registries KW - Treatment Outcome KW - Tumor Necrosis Factor-alpha KW - Uveitis AB -

OBJECTIVE: To evaluate safety and efficacy of adalimumab (ADA) and infliximab (IFX) for the treatment of juvenile idiopathic arthritis-related anterior uveitis (JIA-AU).

METHODS: Starting January 2007, patients with JIA-AU treated with IFX and ADA were managed by a standard protocol and data were entered into the National Italian Registry (NIR). At baseline, all patients were refractory to standard immunosuppressive treatment and/or were corticosteroid-dependent. Data recorded every 3 months included uveitis course, number/type of ocular complications, drug-related adverse events (AE), treatment change or withdrawal, and laboratory measures. Data of patients treated for at least 1 year were retrieved from the NIR and analyzed using descriptive statistics. Treatment efficacy was based on change in uveitis course and in number of ocular complications.

RESULTS: Up to December 2009, data for 108 patients with JIA-AU treated with anti-tumor necrosis factor-α agents were recorded in the NIR and data from 91, with at least 12 months' followup, were included in the study. Forty-eight patients were treated with IFX, 43 with ADA. Forty-seven patients (55.3%) achieved remission of AU, 28 (32.9%) had recurrent AU, and 10 (11.8%) maintained a chronic course. A higher remission rate was observed with ADA (67.4% vs 42.8% with IFX; p = 0.025). Ocular complications decreased from 0.47 to 0.32 per subject. Five patients experienced resolution of structural complications. No patient reported serious AE; 8 (8.8%) experienced 11 minor AE (9 with IFX, 2 with ADA).

CONCLUSION: IFX and ADA appear to be effective and safe for treatment of refractory JIA-related uveitis, with a better performance of ADA in the medium-term period.

VL - 40 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23118110?dopt=Abstract ER -