AB1064\u2005LONG-TERM SAFETY AND EFFICACY OF ADALIMUMAB IN GREEK ADULTS WITH JIA OR NON-INFECTIOUS UVEITIS AT THE TRANSITION PERIOD

Abstract

Background Our previous publication on Juvenile Idiopathic Arthritis (JIA) revealed that half of the pts had flares in adulthood, despite previous administration of several anti-TNFs. Objectives a. To describe the long-term outcome of adults with JIA or non-infectious uveitis (NIU), exposed to Adalimumab (ADA) as the single or last biologic during the transition period. b. To evaluate our model of transition in a subgroup of refractory to conventional DMARDs JIA or NIU pts, in the 1st Greek Transition Clinic for Pediatric Rheumatic Diseases. Methods Retrospective cohort analysis of Greek adults with JIA or NIU between 2004 and 2018. The JIA activity state was assessed by 2 quantitative tools: the Juvenile Arthritis Disease Activity Score-10 (JADAS-10, Clinical Remission [CR], Low, Moderate and High Disease Activity [LDA, MDA, HDA], respectively) and Wallace criteria (CR on/off ADA). Baseline was defined as the 1st ADA dose Results 28 pts were enrolled: 24 JIA pts (female 18), aged 20.6±3.1 yrs, for a f/u of 6.5±3 years (Group-A) and 4 female pts with active uveitis (2 with JIA-associated and 2 with NIU, mean aged: 18.9 yrs, f/u: 2.3 yrs) (Group-B). The age at baseline was 14.1±3.2 yrs in Group-A and 16.7 yrs in Group-B. The lag time from JIA onset to baseline was 6.3±3.8 yrs and the JIA subtypes were: 37.5% polyarthritis RF neg, 33.3% extended oligoarthritis, 20.8% enthesitis-related arthritis, 4.2% persistent oligoarthritis, 4.2% psoriatic arthritis. 11/24 (45.8%) pts (Group-A) and 3/4 pts (Group-B) were ANA positive, 5/24 JIA-pts had a history of uveitis (20.8%). Naïve to anti-TNF drugs were 18 pts (75%) of Group-A and 4/4 from Group-B. The baseline JADAS-10 was 13.9±5.9. The ADA yr-administration was 5.3±2.3 in Group-A and 2 in Group-B. Compliance to ADA had 17/24 (70.8%) pts in Group-A and all from Group-B. Regarding safety, 4/28 patients (14.3%) experienced Events of Special Interest (1/33.6 patient-years), herpes zoster (n=1), anorexia nervosa (n=1), breast fibroadenoma (n=1) and uveitis (n=1). Among the Group-A pts: 4/24 (16.7%) discontinued ADA due to inefficacy and 1/24 due to pregnancy planning. 6/24 pts (25%) achieved CR and discontinued ADA after 5.3±1.6 yrs. CR off ADA lasted 15.5±9.8 mo. The rest 13/24 continued ADA at the last f/u. In Group-B, 3/4 were still on ADA and 1 pt discontinued ADA due to NIU remission after 4.2 yrs and sustained CR 16 mo off ADA. The median% of CR remission on ADA total administration period was 75% in Group-A and 100% in Group-B. Among the ongoing receivers: a) the JIA activity state at the last assessment was: CR 84.6%, LDA 7.7% MDA 7.7% (median JADAS: 0, Group-A), b) 100% were in remission in Group-B. Conclusion 86% of adult pts with JIA or NIU tolerate ADA well. Pts exposed to ADA achieved CR on/off medication in 75% and 25%, respectively. References [1] Dimopoulou D, et al. Rheumatology (Oxford) 2017 *: Despoina Dimopoulou and Maria Trachana contributed equally Disclosure of Interests None declared