Effectiveness and safety of weekly adalimumab for non-infectious chronic anterior uveitis in children
Purpose
Non-infectious chronic anterior uveitis (CAU) remains a therapeutic challenge. The purpose of this study was to analyze the effectiveness and safety of weekly dosing of adalimumab in children with non-infectious refractory CAU.
Methods
Demographic and clinical data of children followed for non- infectious CAU treated with adalimumab were retrospectively reviewed and compared among patients treated with biweekly or weekly dosing of adalimumab. Uveitis control was assessed in the worse eye after 3 and 6 months by a composite endpoint including a reduction of 2 levels of inflammation or normalization to 0 of anterior chamber cells, or aqueous flare according to the SUN classification, or a 50% reduction in local corticosteroid therapy. Secondary objectives were treatment tolerance and risk factors for weekly dosing.
Results
Of the 42 children with CAU, 27/42 (64.3%) were treated with adalimumab, including 24/27 (88.9%) who had juvenile idiopathic arthritis. Escalation to weekly dosing of adalimumab was necessary for 11/27 children (40.7%). After 3 and 6 months of follow-up, 7/11 children (63.6%) met the composite endpoint. Children requiring weekly adalimumab had initially more severe uveitis: anterior chamber cells (p=0.02), aqueous flare (p=0.02), and presence of macular edema (p=0.007). No children had serious systemic side effects.
Conclusion
Weekly adalimumab in children with refractory CAU appears to be an effective and safe treatment for inflammation control and corticosteroid sparing, and an alternative before biologic switching. Controlled studies are needed.
Conflict of interest
No
Authors 1
Last name
GUEUDRY
Initials of first name(s)
J
Department
Department of Ophthalmology - Charles Nicolle University Hospital- CHU ROUEN
City
ROUEN
Country
France
Authors 2
Last name
HUARD
Initials of first name(s)
J
Department
Department of Ophthalmology - Charles Nicolle University Hospital- CHU ROUEN
City
ROUEN
Country
France
Authors 3
Last name
RAYMOND
Initials of first name(s)
S
Department
Department of Pediatrics - Charles Nicolle University Hospital- CHU ROUEN
City
ROUEN
Country
France
Authors 4
Last name
MIHAILESCU
Initials of first name(s)
SD
Department
Innovation, Clinical Research and Educational Unit (CIRCE), Eure-Seine Hospital
City
EVREUX
Country
France
Authors 5
Last name
MURAINE
Initials of first name(s)
M
Department
Department of Ophthalmology - Charles Nicolle University Hospital- CHU ROUEN
City
ROUEN
Country
France
Authors 6
Last name
GRALL LEROSEY
Initials of first name(s)
M
Department
Department of Pediatrics - Charles Nicolle University Hospital- CHU ROUEN
City
ROUEN
Country
France
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