Tynjälä P, Kotaniemi K, Lindahl P, Latva K, Aalto K, Honkanen V, Lahdenne P
Department of Pediatric Rheumatology, Hospital for Children and Adolescents, Helsinki, Finland.
Rheumatology (Oxford). 2008 Mar;47(3):339-44. doi: 10.1093/rheumatology/kem356. Epub 2008 Jan 31.
To evaluate the efficacy of adalimumab in juvenile idiopathic arthritis (JIA)-associated uveitis.
Retrospective observational study of 20 patients with JIA and chronic uveitis on adalimumab treatment. The ocular inflammation and improvement was assessed according to the Standardization of Uveitis Nomenclature criteria.
At the initiation of adalimumab, the mean age of patients was 13.4 yrs and the mean duration of uveitis 8.7 yrs. Seventeen (85%) patients had polyarticular JIA and 19 (95%) had previously been on anti-TNF treatment. The mean duration of adalimumab therapy was 18.7 months. Of the 20 patients, 7 (35%) showed improved activity, 1 (5%) worsening activity and in 12 (60%) no change was observed in the activity of uveitis. Those with improved activity were younger and had shorter disease duration. The mean number of flares/yr decreased from 1.9 to 1.4 during adalimumab treatment. Serious adverse events or side-effects were not observed. Seven patients discontinued adalimumab during the follow-up: six because of inefficacy and one because of inactive uveitis.
Adalimumab is a potential treatment option in JIA-associated uveitis, even in patients non-responsive to previous other anti-TNF therapy.
评估阿达木单抗治疗幼年特发性关节炎(JIA)相关葡萄膜炎的疗效。
对20例接受阿达木单抗治疗的JIA合并慢性葡萄膜炎患者进行回顾性观察研究。根据葡萄膜炎命名标准评估眼部炎症及改善情况。
开始使用阿达木单抗时,患者的平均年龄为13.4岁,葡萄膜炎的平均病程为8.7年。17例(85%)患者为多关节型JIA,19例(95%)患者此前接受过抗TNF治疗。阿达木单抗治疗的平均疗程为18.7个月。20例患者中,7例(35%)炎症活动改善,1例(5%)炎症活动恶化,12例(60%)葡萄膜炎活动无变化。炎症活动改善的患者年龄较小,病程较短。阿达木单抗治疗期间,每年发作的平均次数从1.9次降至1.4次。未观察到严重不良事件或副作用。7例患者在随访期间停用阿达木单抗:6例因无效,1例因葡萄膜炎静止。
阿达木单抗是JIA相关葡萄膜炎的一种潜在治疗选择,即使是对先前其他抗TNF治疗无反应的患者。