Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis
Abstract Background Juvenile idiopathic arthritis (JIA)-associated uveitis and chronic anterior uveitis in children may result in permanent sight loss. Currently, the only licensed and approved treatment for JIA-uveitis is adalimumab. However, even in patients where adalimumab may be initially effec...
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BMC
2025-05-01
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| Series: | Pediatric Rheumatology Online Journal |
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| Online Access: | https://doi.org/10.1186/s12969-025-01107-1 |
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| author | Athimalaipet V Ramanan Andrew D Dick Thomas Jaki Gianmarco Caruso David S Robertson Ashley P Jones Ben Hardwick Sian Drake Balini Balasubramaniam Coziana Ciurtin Ivan Foeldvari Elke O Kreps Alice Leahy Kristina May Pierre Quartier Matthieu P Robert Gabriele Simonini Catherine Guly Michael W Beresford |
| author_facet | Athimalaipet V Ramanan Andrew D Dick Thomas Jaki Gianmarco Caruso David S Robertson Ashley P Jones Ben Hardwick Sian Drake Balini Balasubramaniam Coziana Ciurtin Ivan Foeldvari Elke O Kreps Alice Leahy Kristina May Pierre Quartier Matthieu P Robert Gabriele Simonini Catherine Guly Michael W Beresford |
| author_sort | Athimalaipet V Ramanan |
| collection | DOAJ |
| description | Abstract Background Juvenile idiopathic arthritis (JIA)-associated uveitis and chronic anterior uveitis in children may result in permanent sight loss. Currently, the only licensed and approved treatment for JIA-uveitis is adalimumab. However, even in patients where adalimumab may be initially effective, therapeutic response may subside for example, due to neutralising drug antibodies. Further treatment options are necessary to prevent sight loss in children with uveitis. Interleukin 17 is elevated in uveitis. Inhibition of interleukin 17 ameliorates inflammation in mouse models of uveitis. Secukinumab, an antibody which neutralizes interleukin 17 A, has been shown to be partially effective in adult uveitis. The objective of the Bayesian consensus meeting was to quantify prior expert opinion about the potential utility of secukinumab in treatment of uveitis in JIA. Methods Nine international experts in paediatric rheumatology, paediatric ophthalmology and/or paediatric uveitis took part in a structured Bayesian prior elicitation meeting. Results The final consensus was that adalimumab is expected to yield a higher response rate than secukinumab (mean 0.67 vs. 0.55). The uncertainty in the response rate on secukinumab is somewhat larger than for adalimumab. The equivalent sample size for the prior distribution of adalimumab is 15.7 and 13.1 for secukinumab. The decisions based on the combined evidence would still be driven by the trial data, yet substantial enhancement of the power of the study can be expected by adding information from the equivalent of almost 30 patients. Conclusions The Bayesian analysis adds substantial enhancement of the power of the study and supports a head-to-head trial of adalimumab and secukinumab for JIA-associated uveitis and chronic anterior uveitis. Trial registration ISRCTN 12,427,150 Registration date 14/02/2023. EudraCT 2022-003068-26 Registration date 07/09/2022. |
| format | Article |
| id | doaj-art-45aa81ff4765451aac424bf8a4e82bcd |
| institution | Kabale University |
| issn | 1546-0096 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj-art-45aa81ff4765451aac424bf8a4e82bcd2025-08-20T03:48:15ZengBMCPediatric Rheumatology Online Journal1546-00962025-05-012311710.1186/s12969-025-01107-1Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitisAthimalaipet V Ramanan0Andrew D Dick1Thomas Jaki2Gianmarco Caruso3David S Robertson4Ashley P Jones5Ben Hardwick6Sian Drake7Balini Balasubramaniam8Coziana Ciurtin9Ivan Foeldvari10Elke O Kreps11Alice Leahy12Kristina May13Pierre Quartier14Matthieu P Robert15Gabriele Simonini16Catherine Guly17Michael W Beresford18Bristol Royal Hospital for ChildrenBristol Medical School, University of BristolUniversity of RegensburgUniversity of CambridgeUniversity of CambridgeLiverpool Clinical Trials Centre, The University of LiverpoolLiverpool Clinical Trials Centre, The University of LiverpoolLiverpool Clinical Trials Centre, The University of LiverpoolUniversity Hospitals Birmingham NHS Foundation TrustCentre for Adolescent Rheumatology, University College LondonHamburg Center for Pediatric and Adolescent RheumatologyGhent University HospitalUniversity Hospital Southampton NHS Foundation TrustUniversity Hospital Southampton NHS Foundation TrustUniversité Paris CitéOPHTARA reference center, Ophthalmology Department, Necker-Enfants malades hospital, APHPRheumatology unit, ERN ReCONNET center, FIRENZE and NEUROFARBA Department, Meyer Children’s Hospital IRCCS, University of FlorenceBristol Eye HospitalDepartment of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation TrustAbstract Background Juvenile idiopathic arthritis (JIA)-associated uveitis and chronic anterior uveitis in children may result in permanent sight loss. Currently, the only licensed and approved treatment for JIA-uveitis is adalimumab. However, even in patients where adalimumab may be initially effective, therapeutic response may subside for example, due to neutralising drug antibodies. Further treatment options are necessary to prevent sight loss in children with uveitis. Interleukin 17 is elevated in uveitis. Inhibition of interleukin 17 ameliorates inflammation in mouse models of uveitis. Secukinumab, an antibody which neutralizes interleukin 17 A, has been shown to be partially effective in adult uveitis. The objective of the Bayesian consensus meeting was to quantify prior expert opinion about the potential utility of secukinumab in treatment of uveitis in JIA. Methods Nine international experts in paediatric rheumatology, paediatric ophthalmology and/or paediatric uveitis took part in a structured Bayesian prior elicitation meeting. Results The final consensus was that adalimumab is expected to yield a higher response rate than secukinumab (mean 0.67 vs. 0.55). The uncertainty in the response rate on secukinumab is somewhat larger than for adalimumab. The equivalent sample size for the prior distribution of adalimumab is 15.7 and 13.1 for secukinumab. The decisions based on the combined evidence would still be driven by the trial data, yet substantial enhancement of the power of the study can be expected by adding information from the equivalent of almost 30 patients. Conclusions The Bayesian analysis adds substantial enhancement of the power of the study and supports a head-to-head trial of adalimumab and secukinumab for JIA-associated uveitis and chronic anterior uveitis. Trial registration ISRCTN 12,427,150 Registration date 14/02/2023. EudraCT 2022-003068-26 Registration date 07/09/2022.https://doi.org/10.1186/s12969-025-01107-1Juvenile idiopathic arthritisUveitisBayesian priorClinical trialBiologics |
| spellingShingle | Athimalaipet V Ramanan Andrew D Dick Thomas Jaki Gianmarco Caruso David S Robertson Ashley P Jones Ben Hardwick Sian Drake Balini Balasubramaniam Coziana Ciurtin Ivan Foeldvari Elke O Kreps Alice Leahy Kristina May Pierre Quartier Matthieu P Robert Gabriele Simonini Catherine Guly Michael W Beresford Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis Pediatric Rheumatology Online Journal Juvenile idiopathic arthritis Uveitis Bayesian prior Clinical trial Biologics |
| title | Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| title_full | Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| title_fullStr | Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| title_full_unstemmed | Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| title_short | Bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| title_sort | bayesian trial of adalimumab versus secukinumab for children with juvenile idiopathic arthritis associated uveitis or chronic anterior uveitis |
| topic | Juvenile idiopathic arthritis Uveitis Bayesian prior Clinical trial Biologics |
| url | https://doi.org/10.1186/s12969-025-01107-1 |
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