Novel Drug Combination for Arthritis-Related Complications in Children

Highlights

The auto-immune condition, Juvenile Idiopathic Arthritis (JIA), is associated with severe complications like uveitis, which can lead to blindness.
A combination of Adalimumab and Methotrexate was found to be effective in children and adolescents with JIA-associated uveitis.
The benefit of this combination therapy will have a major impact in children with uveitis all around the world.

A novel drug combination that could help many children with the debilitating Juvenile Idiopathic Arthritis (JIA) has been discovered.

The clinical trial was led by a team of researchers from the Universities of Liverpool and Bristol and funded by Arthritis Research UK and the National Institute for Health Research (NIHR).

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‘Adalimumab therapy helped to control inflammation associated with uveitis in Juvenile Idiopathic Arthritis (JIA), and also lowered the rate of treatment failure.’

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Juvenile Idiopathic Arthritis (JIA) is an auto-immune disease that causes joint inflammation. It mainly occurs in children under the age of 16 years and persists for at least six weeks.

In the U.K, around 1-2 per 1,000 children are said to be affected with auto-immune disease JIA, an incidence of 1 per 10,000. Females are more affected by the condition.

A total of 150,000 children and adolescents have JIA.

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This condition causes many serious complications including uveitis, inflammation of the middle layer of the eyes, which can eventually lead to blindness. In the U.K, over one-third or 5,000 children and adolescents with JIA are likely to develop uveitis.

The findings from this first major trial are a major step forward for children with JIA.

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Stephen Simpson, director of research and programs at Arthritis Research UK, said: "We are thrilled of the outcome of this trial and the huge promise it heralds for transforming the quality of life for the large numbers of children with JIA-associated uveitis. This trial is an impressive example of how investing in exceptional science can ultimately help change how treatment is delivered with direct and immediate benefit for patients."

Drug Combination

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The Co-Chief Investigators of the trail included Professors Michael Beresford and A. V. Ramanan, and colleagues from across the UK.

A randomized, placebo controlled trial on review of 90 of the target 149 patients with JIA-associated uveitis was conducted.

A drug called Adalimumab, in combination with Methotrexate, was found to be effective in children and adolescents with JIA-associated uveitis. Around 75% of the children treated with Adalimumab experienced a significant reduction in eye inflammation.

The group that used the drug had a significantly lower risk of treatment failure than the placebo group.

NHS England has approved the use of Adalimumab in children with uveitis that threatens their sight, and for whom other treatments have proven ineffective.

Opinions

Professor Beresford from University of Liverpool's Institute of Translational Medicine and Alder Hey Children's NHS Foundation Trust said "This landmark trial has demonstrated the commitment and leadership of colleagues across the UK in working closely with patients and parents in tackling a key priority of finding the very best way of caring for children with arthritis and this serious problem of uveitis.

"It has shown the UK to be extremely well placed to deliver challenging trials in children, with the support of the NIHR Clinical Research Network and networks that are in place across the UK." Professor Beresford added.

Professor Ramanan from University Hospitals Bristol NHS Foundation Trust and University of Bristol said, "Uveitis in children is an important cause of loss of vision. This study demonstrates the benefit of Adalimumab in children with uveitis. This is the first randomised trial of its kind worldwide and the results will have a major impact in children with uveitis all around the world."

The drug therapy has already been approved for use and the study is published today in The New England Journal of Medicine.

References

Juvenile Idiopathic Arthritisy - (https://patient.info/doctor/juvenile-idiopathic-arthritis-pro)
A. V. Ramanan et al. Adalimumab plus Methotrexate for Uveitis in Juvenile Idiopathic Arthritis. The New England Journal of Medicine; (2017) DOI: 10.1056/NEJMoa1614160

Source-Medindia