Weekly adalimumab: A promising approach for managing refractory non-infectious chronic pediatric uveitis

This study aimed to evaluate the efficacy and safety of weekly adalimumab (Q1 week) in children with chronic non-infectious uveitis following an inadequate response to biweekly adalimumab (Q2 weeks).

This retrospective, single-center study was conducted in the ophthalmology department of a tertiary center in Marseille, France, and included all patients under 16 years of age with chronic non-infectious uveitis requiring adalimumab dose escalation from Q2 weeks to Q1 week from January 2015 to April 2024.

Seventeen eyes of ten patients were included: six with juvenile idiopathic arthritis, one with idiopathic non-granulomatous anterior uveitis, two with idiopathic granulomatous panuveitis, and one with Vogt-Koyanagi-Harada disease. Eighty percent of patients exhibited active inflammation prior to initiating adalimumab Q1 week, while 80% demonstrated no active anterior inflammation at last follow-up (P=0.041). The mean dose of topical corticosteroids and oral corticosteroids was reduced by the conclusion of follow-up compared to the time of adalimumab dose escalation to Q1 week (7.5mg/day versus 3.9mg/day, P=0.059). The adalimumab dose escalation to Q1 week allowed for complete withdrawal of oral corticosteroids in five out of the seven patients treated with oral corticosteroids (P=0.074). No adverse effects from the adalimumab were reported during the follow-up period.

Escalation to adalimumab Q1 week in children with chronic non-infectious uveitis demonstrated promising efficacy, with a substantial proportion of patients achieving complete resolution of active inflammation.