BackgroundUveitis is the most common extra-articular manifestation of JIA which may lead to sight-threatening ocular complications. Topical corticosteroids are still used in the initial treatment for JIA-associated uveitis. The goal of treatment in these patients should be topical corticosteroid-free remission and prevention of recurrences. The most commonly used corticosteroid-sparing immunomodulatory are TNF-α inhibitors (TNFi), especially adalimumab.Currently, limited data are available about when or how to stop adalimumab when remission of JIA-associated uveitis is presumed.ObjectivesTo evaluate rates of relapse after discontinuation adalimumab in patients with JIA-associated uveitis.MethodsMedical records of 33 patients with JIA-associated uveitis who were successfully treated with adalimumab to a state of topical corticosteroid-free remission and discontinued adalimumab due to a long-term remission were analyzed retrospectively.Remission of uveitis was defined as <1+ cells in the anterior chamber and <1 + vitreous haze grading; relapse was defined as ≥1 cell in the anterior chamber or ≥1 vitreous haze grading [1].ResultsCorticosteroid-sparing control of inflammation was achieved in all patients. Adalimumab was discontinued after 50 (range 12–120) months after initiation of adalimumab. Duration of remission prior to discontinuing adalimumab was 42 (range 6 – 114) months. The mean duration of remission after adalimumab discontinuation was 14 (range 1–59) months. 13 (40%) of patients had flares after less than 12 months after discontinuing adalimumab, 5 (15%) had flares after 12 – 24 months, 15 (45%) had not flared due to 24 months after discontinuation adalimumab and had had a long-term non-biological remission. Disease was successfully controlled in 11(33%) patients with non-biological DMARDs, 22 (66%) patients restarted biological therapy after flares, due to lack of improvement after non-biological DMARDs. All patients in whom biological therapy was reinitiated responded satisfactorily. None of the flared patients didn’t require restarting corticosteroids.ConclusionCorticosteroid-sparing control of inflammation was achieved in all patients. Data from our experience with adalimumab in patients with JIA-associated uveitis suggest that 45 % of patients can be successfully withdrawn from biologics for at least 24 months without disease recurrence.References[1]Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data: results of the First International Workshop. Am J Ophthalmol 2005;140: 509-16.Disclosure of InterestsIrina Tsulukiya: None declared, Ekaterina Alexeeva Speakers bureau: Speaker for Roche, AbbVie, Bristol-Myers, Squibb, MSD, Novartis and Pfizer., Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Eli Lilly, AbbVie, Bristol-Myers Squibb, MSD, Sanofi, Amgen and Novartis., Tatyana Dvoryakovskaya Speakers bureau: Speaker for Roche, AbbVie, Bristol-Myers, Squibb, MSD, Novartis and Pfizer., Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Eli Lilly, AbbVie, Bristol-Myers Squibb, MSD, Sanofi, Amgen and Novartis., Rina Denisova Speakers bureau: Speaker for Roche, AbbVie, MSD, Novartis., Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Sanofi and Novartis., Anna Mamutova Speakers bureau: Speaker for Novartis., Grant/research support from: Financial grants from Eli Lilly., Ksenia Isaeva Grant/research support from: Financial grants from Roche, Novartis and Sanofi., Aleksandra Chomakhidze: None declared, Olga Lomakina Grant/research support from: Financial grants from Pfizer, Eli Lilly., Anna Fetisova Grant/research support from: Financial grants from Amgen., Marina Gautier: None declared, Kristina Chibisova: None declared, Ivan Kriulin Speakers bureau: Speaker for Novartis., Elizaveta Krekhova Speakers bureau: Speaker for Novartis., Maria Botova: None declared

BackgroundSystemic juvenile idiopathic arthritis (sJIA) is the rarest variant of juvenile idiopathic arthritis, characterized by severe course, frequent exacerbations, the development of life-threatening extra-articular manifestations and complications, which requires the use of expensive medications and frequent hospitalizations of patients. In the Russian Federation, the provision of medicines to patients with sJIA is carried out at the expense of the federal budget, in this regard, the Federal Register of sJIA was created in 2018.ObjectivesTo analyze biologic therapy in patients with sJIA according to the data of the Federal Register of the Russian Federation.MethodsRetrospective analysis of epicrisis of patients receiving biologic therapy with a diagnosis of sJIA included in the Federal Register of the Russian Federation. The analysis included patients receiving the following drugs of biologic therapy: tocilizumab, сanakinumab, etanercept, adalimumab.ResultsIn 2018, 582 patients receiving biologic therapy were included in the Federal Register. Since 2019, the number of patients has steadily increased: in 2019 there were 796, in 2020 - 949, in 2021 - 1041 patients.The Federal Register of the Russian Federation includes patients under the age of 18 (in 2018 – 471, in 2019 – 666, in 2020 – 806, in 2021 – 790 patients) and patients over the age of 18 (in 2018 – 111, in 2019 – 130, in 2020 – 143, in 2021 – 250 patients).During the four-year follow-up, patients receiving tocilizumab predominate - on average 72.25% (in 2018 – 74%, in 2019 – 73.1%, in 2020 – 70.3%, in 2021 – 71.6% of patients).Therapy with using of TNF-α inhibitors remains without statistically significant dynamics: in 2018 – 38 (6.5%) received etanercept, in 2019 – 42 (5.3%), in 2020 – 44 (4.6%), in 2021 – 46 (4.4%); in 2018 – 22 (3.8%) received adalimumab, in 2019 – 25 (3.1%), in 2020 – 27 (2.9%), in 2021 – 29 (2.8%) patients.The number of patients receiving сanakinumab has more than doubled since 2018 (in 2018 – 91 (15%), in 2019 – 147 (18.5%), in 2020 – 210 (22.3%), in 2021 - 220 (21.1%) patients.ConclusionThe number of patients receiving biologic therapy with sJIA in the Russian Federation has increased, which is due to the natural growth of the disease and more affordable provision of patients with sJIA by the state.References[1]Lee JJY, Schneider R. Systemic Juvenile Idiopathic Arthritis. Pediatr Clin North Am. 2018 Aug;65(4):691-709. doi: 10.1016/j.pcl.2018.04.005. PMID: 30031494.Disclosure of InterestsMaria Botova: None declared, Ekaterina Alexeeva Speakers bureau: Speaker for Roche, AbbVie, Bristol-Myers, Squibb, MSD, Novartis and Pfizer.,, Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Eli Lilly, AbbVie, Bristol-Myers Squibb, MSD, Sanofi, Amgen and Novartis.,, Tatyana Dvoryakovskaya Speakers bureau: Speaker for Roche, AbbVie, Bristol-Myers, Squibb, MSD, Novartis and Pfizer.,, Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Eli Lilly, AbbVie, Bristol-Myers Squibb, MSD, Sanofi, Amgen and Novartis.,, Rina Denisova Speakers bureau: Speaker for Roche, AbbVie, MSD, Novartis.,, Grant/research support from: Financial grants from Roche, Pfizer, Centocor, Sanofi and Novartis.,, Anna Mamutova Speakers bureau: Speaker for Novartis.,, Grant/research support from: Financial grants from Eli Lilly.,, Ksenia Isaeva Grant/research support from: Financial grants from Roche, Novartis and Sanofi.,, Aleksandra Chomakhidze: None declared, Olga Lomakina Grant/research support from: Financial grants from Pfizer, Eli Lilly.,, Anna Fetisova Grant/research support from: Financial grants from Amgen.,, Marina Gautier: None declared, Kristina Chibisova: None declared, Elizaveta Krekhova Speakers bureau: Speaker for Novartis.,, Ivan Kriulin Speakers bureau: Speaker for Novartis.,, Irina Tsulukiya: None declared, Tatyana Kriulina: None declared, Natalya Kondratyeva: None declared