BRIEF REPORT Safety of weekly adalimumab in the treatment of juvenile idiopathic arthritis and pediatric chronic uveitis Colleen K. Correll 1 & Danielle R. Bullock 1 & Rachel M. Cafferty 2 & Richard K. Vehe 1 Received: 3 August 2017 /Revised: 17 October 2017 /Accepted: 23 October 2017 # International League of Associations for Rheumatology (ILAR) 2017 Abstract Weekly adalimumab dosing is used to treat juvenile idiopathic arthritis (JIA), uveitis, and other pediatric rheumatic diseases, but the safety of such dosing has not previously been studied. A retrospective chart review was conducted to assess the safety of weekly adalimumab. Demographic and clinical data were collected. Basic descriptive analysis was performed to assess for adverse events from weekly adalimumab. Sixty- nine patients at the University of Minnesota or Gillette Children’ s Hospital were identified as treated with weekly adalimumab. Sixty (87%) were eligible for the chart review. Weekly adalimumab was used most commonly to treat uveitis (28%, 17/60) and rheumatoid factor-negative polyarticular JIA (25%, 15/60). Mean age at the start of weekly dosing was 13.9 years. The majority of patients were concurrently treated with a non-steroidal anti-inflammatory drug and meth- otrexate. Fifty-three (90%) patients continued weekly dosing for greater than 3 months. The mean duration of weekly adalimumab was 2 years. Throughout the duration of weekly dosing, 24/60 (40%) patients had documented minor infections not requiring antimicrobials and 24/60 (40%) had documented infections requiring antimicrobial treatment. Only three patients (5%) had an infection requiring hospitali- zation. Two patients (3%) developed autoimmune disease. Laboratory abnormalities and injection site reactions were rare. Weekly adalimumab was used most commonly to treat uveitis and rheumatoid factor-negative polyarticular JIA, and mean duration of weekly dosing was 2 years. Serious adverse events were rare. Keywords Adalimumab . Juvenile idiopathic arthritis . Pediatric rheumatology . Uveitis Introduction Every other week (EOW) dosing of adalimumab is Food and Drug Administration (FDA)-approved for the treatment of children with moderate-to-severe polyarticular juvenile idio- pathic arthritis (JIA) [1, 2]. Adalimumab is also commonly used off-label in the treatment of several other pediatric rheu- matic diseases including enthesitis-related JIA, oligoarticular JIA, juvenile psoriatic arthritis, and chronic uveitis [3–5]. In clinical practice, adalimumab is sometimes escalated from EOW to weekly dosing, an off-label dosing regimen, to achieve better control of these pediatric rheumatic diseases. While weekly adalimumab has been demonstrated to be both effective and safe in the management of several autoimmune diseases in adults as well as Crohn’ s disease in children, there have been no studies aimed at evaluating the safety of weekly adalimumab in children with rheumatic diseases [6–11]. Our primary objective for this study was to assess the safety of weekly adalimumab. To achieve this objective, we conducted a retrospective chart review of patients in the pediatric rheu- matology clinic who were treated with weekly adalimumab. * Colleen K. Correll corr0250@umn.edu Danielle R. Bullock brue0190@umn.edu Rachel M. Cafferty caffe016@umn.edu Richard K. Vehe vehex001@umn.edu 1 Division of Rheumatology, Department of Pediatrics, University of Minnesota, 6th Floor East Building Rm M668, 2450 Riverside Ave, Minneapolis, MN 55454, USA 2 Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, USA Clin Rheumatol https://doi.org/10.1007/s10067-017-3890-4