Clinical Characteristics and Outcomes of JIA Uveitis Patients After Discontinuation or Tapering of Adalimum
Accept poster if oral is not possible ?
Yes
Purpose
To describe the clinical characteristic and outcomes of JIA-uveitis patients with relapse after discontinuation or tapering of Adalimumab.
Methods
Retrospective case series of JIA-uveitis patients treated with Adalimumab, who relapsed after quiescence when treatment was stopped or tapered.
Results
Medical records of 9 patients (8 females) were reviewed. Mean age at JIA and uveitis diagnoses were 3.6 (SD ± 3.29) and 6.2 years (SD ± 4.1), respectively. Median interval from diagnosis to Adalimumab treatment was 22.1 (IQR 50.4) for JIA and 6.44 (IQR 20.5) months for uveitis. Mean inactivity duration was 19.5 (SD ± 9.8) months; all were steroid-free, 4 on Adalimumab alone, and 5 on Adalimumab + Methotrexate (MTX). Relapse occurred on average at 4.9 (SD ± 2.6) months post-treatment stop/tapering. Five relapsed off Adalimumab, four during tapering; mean LogMAR VA at relapse was 0.09 (SD ± 0.08). Five were asymptomatic; four showed ocular/joint symptoms. One patient developed uveitis at tapering for JIA. Rescue treatment included resuming Adalimumab or MTX; none required oral corticosteroids, but six required topical and two intra-articular steroids. Uveitis resolved in 2.8 (SD ± 2.4) months post-rescue; three patients relapsed again with further tapering
Conclusion
Uveitis relapse may occur within 8 weeks post-Adalimumab tapering; slow reduction is recommended. Close monitoring is essential, as patients may be asymptomatic during relapse. None required systemic corticosteroids for rescue.
Conflict of interest
No
1
Last name
NAVARRETE
Initials of first name(s)
A
Department
Ophthalmology department, Hadassah Medical Center
City
Jerusalem
Country
Israel
2
Last name
Amer
Initials of first name(s)
R
Department
Ophthalmology department, Hadassah Medical Center
City
Jerusalem
Country
Israel
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