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Safety of weekly adalimumab in the treatment of juvenile idiopathic arthritis and pediatric chronic uveitis

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Abstract

Weekly adalimumab dosing is used to treat juvenile idiopathic arthritis (JIA), uveitis, and other pediatric rheumatic diseases, but the safety of such dosing has not previously been studied. A retrospective chart review was conducted to assess the safety of weekly adalimumab. Demographic and clinical data were collected. Basic descriptive analysis was performed to assess for adverse events from weekly adalimumab. Sixty-nine patients at the University of Minnesota or Gillette Children’s Hospital were identified as treated with weekly adalimumab. Sixty (87%) were eligible for the chart review. Weekly adalimumab was used most commonly to treat uveitis (28%, 17/60) and rheumatoid factor-negative polyarticular JIA (25%, 15/60). Mean age at the start of weekly dosing was 13.9 years. The majority of patients were concurrently treated with a non-steroidal anti-inflammatory drug and methotrexate. Fifty-three (90%) patients continued weekly dosing for greater than 3 months. The mean duration of weekly adalimumab was 2 years. Throughout the duration of weekly dosing, 24/60 (40%) patients had documented minor infections not requiring antimicrobials and 24/60 (40%) had documented infections requiring antimicrobial treatment. Only three patients (5%) had an infection requiring hospitalization. Two patients (3%) developed autoimmune disease. Laboratory abnormalities and injection site reactions were rare. Weekly adalimumab was used most commonly to treat uveitis and rheumatoid factor-negative polyarticular JIA, and mean duration of weekly dosing was 2 years. Serious adverse events were rare.

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Acknowledgements

The authors would like to thank Betty Bishop, Registered Nurse, for proposing this research idea.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Pediatrics, University of Minnesota, 6th Floor East Building Rm M668, 2450 Riverside Ave, Minneapolis, MN, 55454, USA

    Colleen K. Correll, Danielle R. Bullock & Richard K. Vehe

  2. Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN, 55454, USA

    Rachel M. Cafferty

Authors
  1. Colleen K. Correll
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  2. Danielle R. Bullock
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  3. Rachel M. Cafferty
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  4. Richard K. Vehe
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Corresponding author

Correspondence to Colleen K. Correll.

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All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. This study was approved by the University of Minnesota Institutional Review Board (IRB Code Number: 1511M80622).

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Correll, C.K., Bullock, D.R., Cafferty, R.M. et al. Safety of weekly adalimumab in the treatment of juvenile idiopathic arthritis and pediatric chronic uveitis. Clin Rheumatol 37, 549–553 (2018). https://doi.org/10.1007/s10067-017-3890-4

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  • DOI: https://doi.org/10.1007/s10067-017-3890-4

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