Adalimumab plus MTX effective in JIA-associated uveitis
Combination therapy with methotrexate (MTX) and adalimumab, a human anti–tumour necrosis factor α monoclonal antibody, is effective in the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis, according to a recent report.
In the multicentre, double-blind study, researchers assessed the efficacy and safety of adalimumab in children and adolescents ≥2 years of age who had active JIA-associated uveitis and who were receiving a stable dose of MTX. The children were randomized in a 2:1 ratio to receive subcutaneous adalimumab (20 or 40 mg based on body weight) or placebo every 2 weeks until treatment failure or until 18 months had elapsed. They were followed-up for 2 years from the time of randomization. The primary endpoint was time to treatment failure.
The trial was halted early when the prespecified stopping criteria were met after the enrolment of 90 of 114 patients. It was clear that the therapy was effective as the treatment failure rate was 27 percent among adalimumab recipients but 60 percent among those in the placebo group (hazard ratio (HR), 0.25, 95 percent confidence interval (CI) 0.12–0.49; p<0.0001 (this HR was the prespecified stopping boundary). However, the rates of adverse events (10.07 events/patient-year vs 6.51 events/patient-year) and serious adverse events (0.29 events/patient-year vs 0.19 events/patient-year) were also higher among adalimumab recipients.