Frontiers in immunology · 2026
Association of serum adalimumab levels and immunogenicity with clinical response in non-infectious uveitis: a real-world cohort study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Otal Pau, Seco-Orriols Julia, Miguel-Escuder Lucía, Moll-Udina Aina, Sainz-de-la-Maza Maite, Rodríguez-Pintó Ignasi, Hereu Mireia, P Codes Juan, Adán Alfredo, Llorenç Víctor
Аннотация
PURPOSE: To evaluate serum adalimumab (ADA) levels in patients with non-infectious uveitis (NIU), identify factors associated with drug exposure-including anti-adalimumab antibodies (AAA)-and assess their relationship with control of intraocular inflammation.
METHODS: This retrospective, observational, single-center study included patients with NIU treated with ADA who underwent at least one proactive assessment of serum ADA levels and AAA between October 2019 and January 2024 at Hospital Clínic de Barcelona (Spain).
RESULTS: A total of 135 measurements were obtained from 65 patients. Mean serum ADA levels were higher in patients with complete response (8.28 µg/mL) compared with partial responders (5.57 µg/mL; p = 0.016) and non-responders (6.21 µg/mL; p = 0.012). AAA were detected in 18/135 measurements (13.3%). Patients with detectable AAA had markedly lower serum ADA levels (1.44 µg/mL; p < 0.0001). Lower ADA levels were also associated with male sex (p = 0.011), obesity (body mass index >30 kg/m²; p = 0.006), panuveitis (p < 0.0001), presence of vitritis (p = 0.0002), and longer disease duration (p < 0.0001). No significant differences were observed between ADA monotherapy and combination therapy with conventional immunomodulators (p = 0.91).
CONCLUSIONS: In NIU, patients achieving complete inflammatory control showed higher serum ADA levels than those with partial response or persistent disease activity, suggesting an association between drug exposure and inflammatory control. ADA exposure is influenced by patient- and disease-related factors, including body mass index, inflammatory burden, anatomical classification, immunogenicity, and dosing strategy. These findings support a potential role for proactive therapeutic drug monitoring to guide individualized treatment strategies.
METHODS: This retrospective, observational, single-center study included patients with NIU treated with ADA who underwent at least one proactive assessment of serum ADA levels and AAA between October 2019 and January 2024 at Hospital Clínic de Barcelona (Spain).
RESULTS: A total of 135 measurements were obtained from 65 patients. Mean serum ADA levels were higher in patients with complete response (8.28 µg/mL) compared with partial responders (5.57 µg/mL; p = 0.016) and non-responders (6.21 µg/mL; p = 0.012). AAA were detected in 18/135 measurements (13.3%). Patients with detectable AAA had markedly lower serum ADA levels (1.44 µg/mL; p < 0.0001). Lower ADA levels were also associated with male sex (p = 0.011), obesity (body mass index >30 kg/m²; p = 0.006), panuveitis (p < 0.0001), presence of vitritis (p = 0.0002), and longer disease duration (p < 0.0001). No significant differences were observed between ADA monotherapy and combination therapy with conventional immunomodulators (p = 0.91).
CONCLUSIONS: In NIU, patients achieving complete inflammatory control showed higher serum ADA levels than those with partial response or persistent disease activity, suggesting an association between drug exposure and inflammatory control. ADA exposure is influenced by patient- and disease-related factors, including body mass index, inflammatory burden, anatomical classification, immunogenicity, and dosing strategy. These findings support a potential role for proactive therapeutic drug monitoring to guide individualized treatment strategies.