Horton, S; Jones, AP; Guly, CM; Hardwick, B; Beresford, MW; Lee, RWJ; Dick, AD; Horton, S; Jones, AP; Guly, CM; Hardwick, B; Beresford, MW; Lee, RWJ; Dick, AD; Ramanan, AV; - view fewer (2019) Adalimumab in Juvenile Idiopathic Arthritis–Associated Uveitis: 5-Year Follow-up of the Bristol Participants of the SYCAMORE Trial. American Journal of Ophthalmology , 207 pp. 170-174. 10.1016/j.ajo.2019.06.007.

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Abstract

PURPOSE: To determine longer-term outcomes of participants enrolled from a single center in the SYCAMORE trial, a randomized placebo-controlled trial of adalimumab versus placebo in children with juvenile idiopathic arthritis-associated uveitis (JIA-U) uncontrolled on methotrexate. DESIGN: Retrospective interventional case series. METHODS: Medical records of all 28 SYCAMORE participants recruited at the Bristol Eye Hospital were reviewed at approximately 3-monthly intervals up to 5 years from the trial randomization date. Uveitis activity, treatment course, visual outcomes, ocular complications and adverse events were recorded. Data are presented using summary statistics. RESULTS: Following withdrawal of the investigational medicinal product (IMP), 25 of the 28 participants were started on adalimumab for active juvenile idiopathic arthritis-associated uveitis (JIA-U). Of the 12 participants in the active treatment arm of the SYCAMORE study, 11 (92%) were restarted on adalimumab after withdrawal of the IMP for active JIA-U (median time to flare 188 days (range 42-413)). Two participants stopped adalimumab for uncontrolled JIA-U. One participant had a reduction in vision to 0.3 due to cataract. Mean visual acuity for the remaining 27 participants was -0.04 (right eye) and -0.05 (left eye). CONCLUSIONS: Drug-induced remission of JIA-U did not persist when adalimumab was withdrawn after 1-2 years treatment. Adalimumab was well tolerated and visual acuity outcomes were excellent.

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