Leinonen Sanna T, Aalto Kristiina, Kotaniemi Kaisu M, Kivelä Tero T
Department of Ophthalmology, University of Helsinki, Helsinki University Hospital, Finland.
Department of Paediatrics, University of Helsinki, Helsinki University Hospital, Finland.
Clin Exp Rheumatol. 2017 Nov-Dec;35(6):1043-1046. Epub 2017 Nov 14.
To evaluate the association of adalimumab trough levels and anti-adalimumab antibodies with activity of uveitis in juvenile idiopathic arthritis-related uveitis.
This was a retrospective observational case series in a clinical setting at the Department of Ophthalmology, Helsinki University Hospital, Finland in 2014-2016. Thirty-one paediatric patients with chronic anterior juvenile idiopathic arthritis-related uveitis in 58 eyes and who had been on adalimumab ≥6 months were eligible for the study. Uveitis activity during adalimumab treatment, adalimumab trough levels and anti-adalimumab antibody levels were recorded.
Anti-adalimumab antibody levels ≥12 AU /ml were detected in nine patients (29%). This level of anti-adalimumab antibodies was associated with a higher grade of uveitis (p<0.001), uveitis that was not in remission (p=0.001) and with lack of concomitant methotrexate therapy (p=0.043). In patients with anti-adalimumab antibody levels <12 AU/ml, higher serum trough levels did not associate with better control of uveitis (p=0.86).
Adalimumab treatment might be better guided by monitoring anti-adalimumab antibody formation in treating JIA-related uveitis.
评估阿达木单抗谷浓度及抗阿达木单抗抗体与青少年特发性关节炎相关葡萄膜炎活动度之间的关联。
这是一项回顾性观察性病例系列研究，于2014年至2016年在芬兰赫尔辛基大学医院眼科临床环境中进行。31例患有慢性前部青少年特发性关节炎相关葡萄膜炎的儿科患者共58只眼，且接受阿达木单抗治疗≥6个月，符合研究条件。记录阿达木单抗治疗期间的葡萄膜炎活动度、阿达木单抗谷浓度及抗阿达木单抗抗体水平。
9例患者（29%）检测到抗阿达木单抗抗体水平≥12 AU/ml。这种抗阿达木单抗抗体水平与更高等级的葡萄膜炎（p<0.001）、未缓解的葡萄膜炎（p=0.001）以及未联合使用甲氨蝶呤治疗（p=0.043）相关。在抗阿达木单抗抗体水平<12 AU/ml的患者中，较高的血清谷浓度与更好地控制葡萄膜炎无关（p=0.86）。
在治疗青少年特发性关节炎相关葡萄膜炎时，监测抗阿达木单抗抗体的形成可能有助于更好地指导阿达木单抗治疗。
