Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis
Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis
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DOI：
10.1136/archdischild-2018-315060
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发表时间：
2019-03-01
影响因子：
5.2
通讯作者：
Jahnel, Joerg
中科院分区：
文献类型：
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作者：
Skrabl-Baumgartner, Andrea;Seidel, Gerald;Jahnel, Joerg
目的评价抗阿达利单抗(ADA)抗体(AAA)对青少年特发性关节炎(JIA)相关性葡萄膜炎长期应用抗ADA抗体(ADA)对血清ADA水平和葡萄膜炎活动度的影响。每隔6年定期检测AAA、血清ADA谷值和葡萄膜炎活动度。7例永久性AAA与检测不到的ADA谷值和反应丧失(LOR)相关。4例检测到一过性AAA，ADA谷值和葡萄膜炎对治疗的反应可测量，2例检测到永久性AAA与LOR相关。在无AAA的患者中，伴随免疫抑制药物的使用显著增加(p<；0.05)。结论AAA相关的LOR在ADA治疗JIA相关性葡萄膜炎的长期治疗中经常发生。伴随的免疫抑制治疗可显著降低AAA引起的LOR风险。
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.