TNF alpha-blockers in JIA-associated uveitis: therapeutical benefit and withdrawal possibilities
Purpose
To determine the proportion of successful discontinuation of TNF alpha-blockers in patients with Juvenile idiopathic arthritis-associated uveitis.
Methods
A retrospective observational multicentric study with data from three French tertiary uveitis centers; La Pitie Salpetriere, Kremlin Bicetre and Nantes University Hospitals. The minimal follow-up was 4 years, ranging from 2001 to 2023.
Results
Thirty-two children were included. The mean age at onset was 6 years [range 1-18y]. Adalimumab was the most used TNF-alpha blocker. Drug discontinuation was proposed in 30% of cases. In this group, one third did not present any recurrence at the end of the follow-up.
Eventually, 10% of the 32 patients had a successful withdrawal of anti-TNF biotherapies (n=3). The mean delay of discontinuation was 50 months after the last uveitis flare-up in this group [range 7–92m] vs 37 months in the failed discontinuation group [range 21–71m] (p = 0,5).
In the failed discontinuation group (n=7), the mean delay between treatment withdrawal and uveitis relapse was 5.2 months [range 2-9,2 m.]. In the successful withdrawal group, the patients are meanly free of relapse for 66 months [range 22-118 m]. A successful discontinuation was significantly associated with an older age at onset of uveitis (11y vs 4.5y; p=0.04). An association trend emerged with successful methotrexate discontinuation (p=0,2).
Conclusion
TNF alpha-blockers appear as a suspensive therapy. They prevent from recurrences in patients with chronic stable uveitis. The discontinuation mostly ends with a relapse in less than 6 months. Discontinuation was successful in only 10% of patients. An older age at onset of uveitis is a favourable prognostic factor.
Conflict of interest
No
Authors 1
Last name
CHABBI
Initials of first name(s)
I
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
Authors 2
Last name
LAM
Initials of first name(s)
D
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
Authors 3
Last name
TOUHAMI
Initials of first name(s)
S
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
Authors 4
Last name
FARDEAU
Initials of first name(s)
C
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
Authors 5
Last name
WEBER
Initials of first name(s)
M
Department
CHU DE NANTES
City
NANTES
Country
France
Authors 6
Last name
COURET
Initials of first name(s)
C
Department
CHU DE NANTES
City
NANTES
Country
France
Authors 7
Last name
LABETOULLE
Initials of first name(s)
M
Department
CHU KREMLIN BICETRE
City
Paris
Country
France
Authors 8
Last name
ROUSSEAU
Initials of first name(s)
A
Department
CHU KREMLIN BICETRE
City
Paris
Country
France
Authors 9
Last name
QUARTIER
Initials of first name(s)
P
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
Authors 10
Last name
BODAGHI
Initials of first name(s)
B
Department
CHU LA PITIE SALPETRIERE
City
Paris
Country
France
This website uses cookies to ensure you get the best experience on our website.
Learn more