Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring?
Background: Adalimumab, an anti-TNF-α biologic agent, has emerged as a principal treatment option for patients with non-infectious uveitis. The influence of adalimumab anti-drug antibodies (AAA) on the efficacy of adalimumab therapy is not yet fully understood. We aim to understand their clinical im...
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2024-12-01
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| author | Lynn S. zur Bonsen Vitus A. Knecht Anne Rübsam Dominika Pohlmann Uwe Pleyer |
| author_facet | Lynn S. zur Bonsen Vitus A. Knecht Anne Rübsam Dominika Pohlmann Uwe Pleyer |
| author_sort | Lynn S. zur Bonsen |
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| description | Background: Adalimumab, an anti-TNF-α biologic agent, has emerged as a principal treatment option for patients with non-infectious uveitis. The influence of adalimumab anti-drug antibodies (AAA) on the efficacy of adalimumab therapy is not yet fully understood. We aim to understand their clinical implications in the context of therapeutic drug monitoring and the factors contributing to the formation of these antibodies. Methods: We conducted a retrospective analysis of 114 patients with non-infectious uveitis who developed AAA while undergoing adalimumab therapy. Results: Among the 114 AAA-positive uveitis patients, a significant correlation was observed between AAA levels and reduced adalimumab serum levels (r = −0.58, <i>p</i> < 0.001). The mean time to AAA detection was 2.1 years (range 0.1–11.9 years), with 45.6% of cases identified through routine testing. If AAA levels were initially low, subsequent measurements for AAA were more likely to become negative during treatment (r = 0.63, <i>p</i> < 0.001). Higher AAA concentrations were associated with a shorter time to detection (r = −0.27, <i>p</i> = 0.01) and younger age (r = −0.21, <i>p</i> = 0.03). There was a trend, though no significant influence, of concomitant immunosuppression with prednisolone ≤ 7.5 mg or methotrexate on antibody formation (<i>p</i> = 0.18). No significant difference was observed in AAA levels between uveitis subtypes. Conclusions: Higher AAA concentrations are associated with lower adalimumab serum levels in uveitis patients. Routine clinical testing is essential for optimal therapeutic drug monitoring to prevent early loss of effectiveness. |
| format | Article |
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| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-e7aeb363effd4fc5be465e57803eadde2025-08-20T02:53:40ZengMDPI AGBiomedicines2227-90592024-12-011212278210.3390/biomedicines12122782Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring?Lynn S. zur Bonsen0Vitus A. Knecht1Anne Rübsam2Dominika Pohlmann3Uwe Pleyer4Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, GermanyBackground: Adalimumab, an anti-TNF-α biologic agent, has emerged as a principal treatment option for patients with non-infectious uveitis. The influence of adalimumab anti-drug antibodies (AAA) on the efficacy of adalimumab therapy is not yet fully understood. We aim to understand their clinical implications in the context of therapeutic drug monitoring and the factors contributing to the formation of these antibodies. Methods: We conducted a retrospective analysis of 114 patients with non-infectious uveitis who developed AAA while undergoing adalimumab therapy. Results: Among the 114 AAA-positive uveitis patients, a significant correlation was observed between AAA levels and reduced adalimumab serum levels (r = −0.58, <i>p</i> < 0.001). The mean time to AAA detection was 2.1 years (range 0.1–11.9 years), with 45.6% of cases identified through routine testing. If AAA levels were initially low, subsequent measurements for AAA were more likely to become negative during treatment (r = 0.63, <i>p</i> < 0.001). Higher AAA concentrations were associated with a shorter time to detection (r = −0.27, <i>p</i> = 0.01) and younger age (r = −0.21, <i>p</i> = 0.03). There was a trend, though no significant influence, of concomitant immunosuppression with prednisolone ≤ 7.5 mg or methotrexate on antibody formation (<i>p</i> = 0.18). No significant difference was observed in AAA levels between uveitis subtypes. Conclusions: Higher AAA concentrations are associated with lower adalimumab serum levels in uveitis patients. Routine clinical testing is essential for optimal therapeutic drug monitoring to prevent early loss of effectiveness.https://www.mdpi.com/2227-9059/12/12/2782adalimumabantidrug antibodiesanti-TNFtherapeutic drug monitoringnon-infectious uveitis |
| spellingShingle | Lynn S. zur Bonsen Vitus A. Knecht Anne Rübsam Dominika Pohlmann Uwe Pleyer Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? Biomedicines adalimumab antidrug antibodies anti-TNF therapeutic drug monitoring non-infectious uveitis |
| title | Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? |
| title_full | Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? |
| title_fullStr | Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? |
| title_full_unstemmed | Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? |
| title_short | Adalimumab Autoantibodies in Uveitis Patients: Do We Need Routine Drug Monitoring? |
| title_sort | adalimumab autoantibodies in uveitis patients do we need routine drug monitoring |
| topic | adalimumab antidrug antibodies anti-TNF therapeutic drug monitoring non-infectious uveitis |
| url | https://www.mdpi.com/2227-9059/12/12/2782 |
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