May 30, 2013
1 min read
Save

Adalimumab more effective as first-line anti-TNF-a therapy for uveitis

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Adalimumab had better efficacy when used as the first anti-tumor necrosis factor-alpha treatment for childhood chronic uveitis than when used after infliximab failed, according to study results.

In an open-label, multicenter study, Italian researchers evaluated 26 patients (median age, 8.6 years; 14 female) with resistant, noninfectious active uveitis. The children were enrolled in two treatment groups, due to the refractory course of uveitis to previous disease-modifying antirheumatic drugs. Fourteen children (group 1; 10 with juvenile idiopathic arthritis (JIA), three with idiopathic uveitis and one with Behçet’s syndrome) received adalimumab (24 mg/m2, every 2 weeks) as first anti-tumor necrosis factor-alpha (anti-TNF-a) treatment.

Twelve children (group 2; seven with JIA, three with idiopathic uveitis, one with early-onset sarcoidosis and one with Behçet’s syndrome) received adalimumab as a second anti-TNF-a therapy, due to loss of efficacy of infliximab, given for at least 1 year at 5 mg/kg to 10 mg/kg at weeks 0, 2 and 6, then every 6 to 8 weeks.

Adalimumab was administered as treatment for at least 1 year to both groups. Time to first relapse after achieving remission was the primary outcome.

During the first 12 months of treatment, group 2 displayed a lower probability to steroid discontinuation (Mantel-Cox chi-square 4.12; P<.004). A higher probability of uveitis remission was experienced by group 1 patients in a long-term follow-up (median ± SE: 18 ± 1.1 months vs. 4 ± 0.6 months; 95% CI, 15.6-27.5 vs. 2.7-5.2).

“The present comparative prospective study … might suggest clinicians to consider adalimumab as a potential starting option in case of childhood chronic refractory uveitis,” the researchers concluded. “Further studies in a larger cohort, in a prospective fashion, preferably by a randomized clinical trial, focused on one disease entity with a sufficient samples size, seem to be advocated to address this point.”

click me