Abstract:  Objective To evaluate the efficacy and safety of adalimumab (ADA) for the treatment of juvenile idiopathic arthritis (JIA) associated uveitis. Design Retrospective case series. Participants 16 patients (28 eyes) with refractory JIA related uveitis who were treated with ADA in Beijing Tongren Hospital from June 2020 to September 2021. 10 cases (18 eyes) presented anterior uveitis, and 6 cases (10 eyes) presented panuveitis. Methods The outpatient medical records of patients were analyzed. All patients underwent ADA subcutaneous injection treatment. For individuals with weight ≥30 kg, the initial dose was 80 mg, and thereafter every 2 weeks, with a dose of 40 mg each time, and the dose was half for those with weight <30 kg. After inflammation was controlled, the dosage of glucocorticoids and immunosuppressants were gradually decreased. Main Outcome Measures Cells and flare in anterior chamber, and vitreous haze, visual acuity, changes of glucocorticoid and immunosuppressant dosage, and side effects of ADA. Results The inflammation of uveitis in all suffered eyes was controlled within 3~6 months after ADA treatment, and the inflammatory cells and flare in anterior chamber, and vitreous haze were all reduced from 2+~3+ to 0~1+. No recurrence was observed after follow-up for ≥12 months. After uveitis was controlled stably with ADA treatment, 8 of 10 patients with anterior uveitis completely stopped all medicines, and the other 2 patients stopped taking immunosuppressants. 4 of 6 patients with panuveitis stopped taking glucocorticoid, only taking immunosuppressants and ADA, and the other 2 patients had reduced the dosage of glucocorticoid and immunosuppressants. After ADA treatment, the visual acuity of 20/28 eyes improved by≥2 lines, and the visual acuity of 8/28 eyes improved by ≥1 line. No serious eye or systemic side effects were observed. Conclusion ADA is effective and safe for the treatment of refractory JIA associated uveitis and can reduce the dosage of systemic glucocorticoids and immunosuppressants. (Ophthalmol CHN, 2023, 32: 320-325)

Key words: adalimumab, uveitis, juvenile idiopathic arthritis