Huang Bo-Han, Hsu Jr-Lin, Huang Hsin-Yi, Huang Jing-Long, Yeh Kuo-Wei, Chen Li-Chen, Lee Wen-I, Yao Tsung-Chieh, Ou Liang-Shiou, Lin Syh-Jae, Su Kuan-Wen, Wu Chao-Yi
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.
Int J Mol Sci. 2025 Jan 30;26(3):1189. doi: 10.3390/ijms26031189.
Adalimumab, a TNF-alpha inhibitor, is approved to treat juvenile idiopathic arthritis (JIA), helping control disease activity and reduce flare frequency. This study aims to investigate predictors of treatment response, including anti-drug antibodies. We reviewed 65 JIA patients (mean age 10.47 ± 3.90 years; 61.5% male) receiving adalimumab for an average of 2.64 ± 0.56 years, with demographics, laboratory parameters, therapeutic regimens, and treatment outcomes recorded. Disease status was evaluated using the Wallace criteria up to 36 months post-treatment initiation, and anti-adalimumab antibody levels were measured after 6 months of treatment. Enthesitis-related arthritis was the most common subtype (64.6%). Inactive disease status was achieved by 83.1% of patients, with 59.3% experiencing relapse. Detectable anti-adalimumab antibody at six months ( = 0.023) and temporomandibular joint (TMJ) involvement ( = 0.038) identified those less likely to achieve inactive disease. An antibody level cutoff of 7.426 ng/mL best predicted response (AUC = 0.808; = 0.008), while high anti-adalimumab antibody levels after treatment ( = 0.032) and an injection intervals over two weeks ( = 0.042) were predictors of future flares. Our results highlight that the presence of anti-adalimumab antibodies six months after treatment is a risk factor for poor response to adalimumab therapy.
阿达木单抗是一种肿瘤坏死因子-α抑制剂，已被批准用于治疗青少年特发性关节炎（JIA），有助于控制疾病活动并减少病情复发频率。本研究旨在调查治疗反应的预测因素，包括抗药物抗体。我们回顾了65例接受阿达木单抗治疗的JIA患者（平均年龄10.47±3.90岁；61.5%为男性），平均治疗时间为2.64±0.56年，记录了患者的人口统计学信息、实验室参数、治疗方案和治疗结果。在治疗开始后长达36个月的时间里，使用华莱士标准评估疾病状态，并在治疗6个月后测量抗阿达木单抗抗体水平。附着点炎相关关节炎是最常见的亚型（64.6%）。83.1%的患者达到疾病非活动状态，其中59.3%经历了复发。治疗6个月时可检测到抗阿达木单抗抗体（P = 0.023）和颞下颌关节（TMJ）受累（P = 0.038）表明这些患者不太可能达到疾病非活动状态。抗体水平临界值为7.426 ng/mL时对反应的预测最佳（AUC = 0.808；P = 0.008），而治疗后抗阿达木单抗抗体水平较高（P = 0.032）和注射间隔超过两周（P = 0.042）是未来病情复发的预测因素。我们的结果强调，治疗6个月后抗阿达木单抗抗体的存在是阿达木单抗治疗反应不佳的一个危险因素。
