Treatment Combo Shows Promise for JIA-Associated Uveitis

In children and adolescents with active juvenile idiopathic arthritis, the combination controls eye inflammation
In children and adolescents with active juvenile idiopathic arthritis, the combination controls eye inflammation

HealthDay News — Treatment with adalimumab plus methotrexate is effective in children and adolescents with active juvenile idiopathic arthritis-associated (JIA-associated) uveitis, according to a study published online April 26 in the New England Journal of Medicine.

Athimalaipet V. Ramanan, from University Hospitals Bristol NHS Foundation Trust in the United Kingdom, and colleagues conducted a multicenter trial in which children and adolescents (≥2 years) who had active JIA-associated uveitis and were taking a stable dose of methotrexate were randomly assigned (2-to-1) to receive either adalimumab (20 mg or 40 mg, according to body weight) or placebo, administered subcutaneously every two weeks. Treatment continued until failure or 18 months, and patients were followed for up to two years from randomization. 

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The researchers met prespecified stopping criteria after the enrollment of 90 of 114 patients. Sixteen treatment failures occurred in 60 patients (27%) in the adalimumab group versus 18 treatment failures in 30 patients (60 percent) in the placebo group (hazard ratio, 0.25). Patients receiving adalimumab reported adverse events more frequently than did those receiving placebo (10.07 events per patient-year versus 6.51 events per patient-year). They also reported more serious adverse events (0.29 events per patient-year versus 0.19 events per patient-year).

"Adalimumab therapy controlled inflammation and was associated with a lower rate of treatment failure than placebo among children and adolescents with active JIA-associated uveitis who were taking a stable dose of methotrexate," conclude the authors.

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