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Rheumatology Advance Access first published online on January 31, 2008
This version published online on February 8, 2008
Rheumatology, doi:10.1093/rheumatology/kem356
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Adalimumab in juvenile idiopathic arthritis-associated chronic anterior uveitis

P. Tynjälä1,2, K. Kotaniemi3, P. Lindahl4, K. Latva5, K. Aalto1, V. Honkanen1 and P. Lahdenne1

1Department of Pediatric Rheumatology, Hospital for Children and Adolescents, Helsinki University Central Hospital, 2Department of Pediatrics, Lohja Hospital, Lohja, 3Department of Ophthalmology, Rheumatism Foundation Hospital, Heinola, 4Department of Ophthalmology, Helsinki University Central Hospital and 5Department of Pediatric Rheumatology, Rheumatism Foundation Hospital, Heinola, Finland.

Correspondence to: P. Tynjälä, Research unit, Hospital for Children and Adolescents, Biomedicum 2 Helsinki, 5th floor, PO Box 448 (Tukholmankatu 8A), 00029 HUS, Finland. E-mail: pirjo.tynjala{at}hus.fi


  Abstract

Objective. To evaluate the efficacy of adalimumab in juvenile idiopathic arthritis (JIA)-associated uveitis.

Methods. Retrospective observational study of 20 patients with JIA and chronic uveitis on adalimumab treatment. The ocular inflammation and improvement was assessed according to the Standardization of Uveitis Nomenclature criteria.

Results. At the initiation of adalimumab, the mean age of patients was 13.4 yrs and the mean duration of uveitis 8.7 yrs. Seventeen (85%) patients had polyarticular JIA and 19 (95%) had previously been on anti-TNF treatment. The mean duration of adalimumab therapy was 18.7 months. Of the 20 patients, 7 (35%) showed improved activity, 1 (5%) worsening activity and in 12 (60%) no change was observed in the activity of uveitis. Those with improved activity were younger and had shorter disease duration. The mean number of flares/yr decreased from 1.9 to 1.4 during adalimumab treatment. Serious adverse events or side-effects were not observed. Seven patients discontinued adalimumab during the follow-up: six because of inefficacy and one because of inactive uveitis.

Conclusion. Adalimumab is a potential treatment option in JIA-associated uveitis, even in patients non-responsive to previous other anti-TNF therapy.

KEY WORDS: Adalimumab, Anti-TNF treatment, Juvenile idiopathic arthritis, Outcome assessment, Uveitis

Submitted 18 April 2007; revised version accepted 6 December 2007.
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