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 2 weeks. Treatment continued until failure or 18 months, and patients were followed for up to 2 years from randomization.
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%) 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,” concluded the authors.
Ramanan AV, Dick AD, Jones AP, et al. Adalimumab plus methotrexate for uveitis in juvenile idiopathic arthritis [published online April 27, 2017]. NEJM. doi:10.1056/NEJMoa1614160