Adalimumab Withdrawal in Uveitis Patients Save

Adalimumab is an effective treatment for juvenile idiopathic arthritis (JIA)-associated uveitis and has been FDA approved for such use - but for how long and can the drug be withdrawn? An adalimumab (ADA) withdrawal trial has shown recurrence of uveitis, arthritis, or both, when the disease was previously controlled on ADA.

 

A multinational, randomised, placebo-controlled trial of 87 JIA-Uveitis patients who had controlled arthritis and uveitis for at least 1 year on adalimumab were randomized (1:1) to either placebo or continued adalimumab (sc, every 2 weeks till week 48 or treatment failure. The primary outcome was the time to treatment failure (recurrence of uveitis or arthritis).

 

A total of 87 patients were enrolled and 2 patients in each group dropped out but data were included in analyses. Treatment failure was seen:

The median time to re-establish sustained disease control (in these placebo patients) after restarting adalimumab was 105 days.

 

Nonserious adverse events were similar between groups (ADA 7.5 events per person-year; PBO 6.8 events per person-year). There were four serious adverse events in the adalimumab group (1 dyspnea, 2 unrelated surgeries, 1 MTX tranaminitis).

 

Only one-third of stable JIA-Uveitis could successfully discontinue adalimumab without flare of eye or joint disease. Of those who flared, all successfully regained control of inflammation (with ADA) by the end of the 48-week study.