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Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis
  1. Andrea Skrabl-Baumgartner1,
  2. Gerald Seidel2,
  3. Beate Langner-Wegscheider2,
  4. Axel Schlagenhauf1,
  5. Jörg Jahnel1
  1. 1 Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria
  2. 2 Department of Ophthalmology, Medical University Graz, Graz, Austria
  1. Correspondence to Dr Andrea Skrabl-Baumgartner, Department of Pediatrics, Medical University Graz, Graz 8036, Austria; andrea.skrabl-baumgartner{at}


Objectives Assessing influence of anti-adalimumab (ADA) antibodies (AAA) on serum trough ADA levels and uveitis activity in long-term ADA treatment of juvenile idiopathic arthritis (JIA)-associated uveitis.

Patients and interventions This prospective observational study included 20 patients from a single centre treated with ADA for active uveitis refractory to conventional disease-modifying antirheumatic drugs. AAA, serum ADA trough levels and uveitis activity were evaluated at regular intervals up to 6 years.

Results AAA were detected in nine patients (45%). Permanent AAA in seven were associated with undetectable ADA trough levels and loss of response (LOR). Transient AAA were detected in four with measurable ADA trough levels and response of uveitis to treatment, followed in two by permanent AAA associated with LOR. Use of concomitant immunosuppression was significantly higher in patients without AAA (p<0.05).

Conclusions AAA-associated LOR frequently occurs in long-term treatment with ADA for JIA-associated uveitis. Concomitant immunosuppressive therapy significantly reduces the risk of LOR due to AAA.

  • uveitis
  • juvenile idiopathic arthritis
  • adalimumab
  • antidrug antibodies

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  • Contributors ASB conceptualised and designed the study and recruited patients and sampled data. ASB drafted the initial manuscript and revised the final manuscript. GS analysed the data and revised the manuscript. BLW and AS analysed the data. JJ helped in designing the study and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained from the parents/guardian.

  • Ethics approval Ethics Committee at the Medical University of Graz.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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