The Humira in non-infectious Uveitis Tapering (HUT) trial
Purpose
To assess feasibility of adalimumab tapering in inactive non-infectious uveitis.
Methods
In this multicenter, retrospective study, non-infectious uveitis patients given adalimumab with a minimum follow-up of 6 months and subsequently tapered were identified. We collected data demographic information, underlying systemic disease, uveitis characteristics and type. Disease-modifying anti-rheumatic that were added or still used after the start of adalimumab were included in the study analysis. We recorded the time (weeks) of inactivity before an attempt at adalimumab taper was done. The tapering schedule was at the discretion of the treating physician and was recorded. Time to tapering failure, if present, was recorded.
Results
328 patients were included (54.6 female; mean subject age 34.3 years). Tapering of adalimumab was begun at 100.8 69.7 weeks. After tapering, recurrence was observed in 130 (39.6%) patients at a mean of 44.7 61.7 weeks.
The main factors associated with a higher rate of recurrences were younger age (HR)=0.83 per decade of increasing age, p<0.0005), Arab (HR=3.33, p=0.005) and white (HR=2.76, p=0.001) race, and a faster speed of tapering of adalimumab (HR=1.26 per unit increase in speed category, p<0.0005). A longer period of uveitis inactivity prior to tapering of adalimumab was associated with a lower rate of recurrence (HR=0.97 per 10-weeks longer period of inactivity, p=0.04).
Conclusion
Adalimumab tapering is feasible in patients who are in stable, long-standing clinical remission. In pediatric patients and patients younger than 40 years of age, physicians should wait for a long period of inactivity before attempting a tapering, and should adopt a slower tapering schedule, especially in Arabs and White.
Conflict of interest
No
Authors 1
Last name
PICHI
Initials of first name(s)
F
Department
Cleveland Clinic Abu Dhabi
City
Abu Dhabi
Country
United Arab Emirates
Authors 2
Last name
Smith
Initials of first name(s)
S
Department
Cleveland Clinic Abu Dhabi
City
Abu Dhabi
Country
United Arab Emirates
Authors 3
Last name
Neri
Initials of first name(s)
P
Department
Cleveland Clinic Abu Dhabi
City
Abu Dhabi
Country
United Arab Emirates
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