Prevention of flare recurrences in childhood-refractory chronic uveitis: An open-label comparative study of adalimumab versus infliximab
Article first published online: 30 MAR 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis Care & Research
Volume 63, Issue 4, pages 612–618, April 2011
How to Cite
Simonini, G., Taddio, A., Cattalini, M., Caputo, R., De Libero, C., Naviglio, S., Bresci, C., Lorusso, M., Lepore, L. and Cimaz, R. (2011), Prevention of flare recurrences in childhood-refractory chronic uveitis: An open-label comparative study of adalimumab versus infliximab. Arthritis Care Res, 63: 612–618. doi: 10.1002/acr.20404
- Issue published online: 30 MAR 2011
- Article first published online: 30 MAR 2011
- Accepted manuscript online: 15 NOV 2010 11:59AM EST
- Manuscript Accepted: 3 NOV 2010
- Manuscript Received: 17 MAY 2010
To compare the efficacy and safety of adalimumab versus infliximab in an open-label prospective, comparative, multicenter cohort study of childhood noninfectious chronic uveitis.
Thirty-three patients (22 females, 11 males, median age 9.17 years) with refractory, vision-threatening, noninfectious active uveitis were enrolled, and received for at least 1 year infliximab (5 mg/kg at weeks 0, 2, and 6, and then every 6–8 weeks) or adalimumab (24 mg/m2 every 2 weeks). The primary outcome was to assess, once remission was achieved, the time of a first relapse. Time to remission, time to steroid discontinuation, and the number of relapses were also considered.
Sixteen children (12 with juvenile idiopathic arthritis [JIA], 3 with idiopathic uveitis, and 1 with Behçet's disease) were recruited in the adalimumab cohort and 17 children (10 with JIA, 5 with idiopathic uveitis, 1 with early-onset sarcoidosis, and 1 with Behçet's disease) were recruited in the infliximab group. Cox regression analysis did not show statistically significant differences between the two groups with regard to time to achieve remission and time to steroid discontinuation, whereas a higher probability of uveitis remission on adalimumab during the time of treatment was shown (Mantel-Cox χ2 = 6.83, P < 0.001). At 40 months of followup, 9 (60%) of 15 children receiving adalimumab compared to 3 (18.8%) of 16 children receiving infliximab were still in remission on therapy (P < 0.02).
Even if limited to a relatively small group, our study suggests that over 3 years of treatment, adalimumab is more efficacious than infliximab in maintaining remission of chronic childhood uveitis.