Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis

Skrabl-Baumgartner, Andrea; Seidel, Gerald; Langner-Wegscheider, Beate; Schlagenhauf, Axel; Jahnel, Jörg

doi:10.1136/archdischild-2018-315060

Cited by 40 publications

(42 citation statements)

References 15 publications

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“…Concomitant use of methotrexate has a protective role against the development of adalimumab ADA [risk ratio 0.33; 95% Confidence interval (95% CI) 0.21, 0.52] (Doeleman et al, 2019). The above findings regarding adalimumab were also reported in relation to patients receiving this drug for JIAassociated uveitis (Skrabl-Baumgartner et al, 2019). In addition, the risk of infusion reactions in patients treated with tocilizumab, infliximab or rilonacept increased in the presence of ADA (Ruperto et al, 2007;Lovell et al, 2013;Yokota et al, 2014).…”

Section: Therapeutic Drug Monitoring and Anti-drug Antibodies As Biomarkers Of Efficacy And Toxicity Of Biologic Treatments In Jiamentioning

confidence: 89%

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

et al. 2021

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Background: Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritis of childhood, characterized by various clinical phenotypes associated with variable prognosis. Significant progress has been achieved with the use of biologic treatments, which specifically block pro-inflammatory molecules involved in the disease pathogenesis. The most commonly used biologics in JIA are monoclonal antibodies and recombinant proteins targeting interleukins 1 (IL-1) and 6 (IL-6), and tumor necrosis factor α (TNF-α). Several biomarkers have been investigated in JIA.Aims: To assess the level of evidence available regarding the role of biomarkers in JIA related to guiding clinical and therapeutic decisions, providing disease prognostic information, facilitating disease activity monitoring and assessing biologic treatment response in JIA, as well as propose new strategies for biologic therapy-related biomarker use in JIA.Methods: We searched PubMed for relevant literature using predefined key words corresponding to several categories of biomarkers to assess their role in predicting and assessing biologic treatment response and clinical remission in JIA.Results: We reviewed serological, cellular, genetic, transcriptomic and imaging biomarkers, to identify candidates that are both well-established and widely used, as well as newly investigated in JIA on biologic therapy. We evaluated their role in management of JIA as well as identified the unmet needs for new biomarker discovery and better clinical applications.Conclusion: Although there are no ideal biomarkers in JIA, we identified serological biomarkers with potential clinical utility. We propose strategies of combining biomarkers of response to biologics in JIA, as well as routine implementation of clinically acceptable imaging biomarkers for improved disease assessment performance.

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Section: Therapeutic Drug Monitoring and Anti-drug Antibodies As Biomarkers Of Efficacy And Toxicity Of Biologic Treatments In Jiamentioning

confidence: 89%

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

et al. 2021

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“…The timing of adalimumab ADA development is controversial: in some adult studies ADA prevalence did not increase with treatment duration, 53 , 54 while in other studies there was a significant increase, with ADA developing between 4.5 months and 12 months of treatment. 9 , 34 , 44 , 50 , 52 , 55 Similarly, studies in JIA showed both trends: a significant increase of ADA with time 35 or no correlation with treatment duration, 30 suggesting that ongoing monitoring to establish their clinical relevance and impact on management is required.…”

Section: Introductionmentioning

confidence: 99%

“… 28 , 30 In JIA, it was noted that transient ADAs (defined as measurable ADAs on up to two consecutive time points which disappeared on subsequent measurements without having any impact on treatment efficacy of toxicity) were not associated with diminished response to medication, whereas permanent ADAs did lower treatment response. 34 …”

Section: Introductionmentioning

confidence: 99%

Impact of immunogenicity on clinical efficacy and toxicity profile of biologic agents used for treatment of inflammatory arthritis in children compared to adults

Parikh

Ponnampalam

Seligmann

et al. 2021

Therapeutic Advances in Musculoskeletal

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The treatment of inflammatory arthritis has been revolutionised by the introduction of biologic treatments. Many biologic agents are currently licensed for use in both paediatric and adult patients with inflammatory arthritis and contribute to improved disease outcomes compared with the pre-biologic era. However, immunogenicity to biologic agents, characterised by an immune reaction leading to the production of anti-drug antibodies (ADAs), can negatively impact the therapeutic efficacy of biologic drugs and induce side effects to treatment. This review explores for the first time the impact of immunogenicity against all licensed biologic treatments currently used in inflammatory arthritis across age, and will examine any significant differences between ADA prevalence, titres and timing of development, as well as ADA impact on therapeutic drug levels, clinical efficacy and side effects between paediatric and adult patients. In addition, we will investigate factors associated with differences in immunogenicity across biologic agents used in inflammatory arthritis, and their potential therapeutic implications.

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“…Tumor necrosis factor (TNF)-alpha blockers (adalimumab and infliximab) are the most commonly used biologic agents in JIA-associated uveitis, and these agents have markedly improved the visual prognosis of the disease. 5,6 However, some patients fail to respond to different immunomodulators, including conventional agents and the more potent biologics, or they are intolerant to these therapies. In this subset of patients, signs of chronic low-grade inflammation and flare in the anterior chamber may persist despite aggressive systemic immunosuppressive therapy.…”

Section: Introductionmentioning

confidence: 99%

Oral phospholipidic curcumin in juvenile idiopathic arthritis-associated uveitis

Miserocchi

Giuffrè

Cicinelli

et al. 2019

European Journal of Ophthalmology

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Purpose: To evaluate the efficacy and the safety of curcumin-phosphatidylcholine complex in children affected by juvenile idiopathic arthritis–associated uveitis as an adjunctive treatment to chronic systemic immunosuppressive therapy. Methods: In this retrospective, longitudinal study, we treated patients affected by juvenile idiopathic arthritis–associated uveitis with residual low-grade inflammatory activity in the anterior chamber with one tablet of curcumin-phosphatidylcholine complex per day, over a year. Low-grade inflammatory activity was characterized by flare 1+ at slit-lamp examination and 10–50 photon counts per ms) at the FC500 laser flare meter. Inactivity of uveitis was defined as complete disappearance of flare at the slit-lamp examination and values <10 ph/ms at laser flare meter. Conversely, recurrence of the uveitis was defined as a one-step increase from baseline in anterior chamber cells levels or laser flare meter measurements >50 ph/ms. Results: A total of 22 out of 27 patients (81%) achieved inactivity at the end of the study. Five patients (19%) did not show a significant reduction in anterior chamber flare, remaining stable throughout the follow-up. Only three episodes of flare-ups in three different patients were recorded. Overall, the treatment was well tolerated by all patients and no ocular discomfort, ocular side effects, or allergic reactions were registered. Conclusion: Adjunctive therapy with curcumin in patients affected by juvenile idiopathic arthritis–associated uveitis improves mild chronic anterior chamber flare and presents a good safety profile. Despite being mild, anterior chamber inflammation should be minimized to avoid the development of sight-threatening complications in these patients.

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Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis

Abstract: 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.

Cited by 40 publications

References 15 publications

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Impact of immunogenicity on clinical efficacy and toxicity profile of biologic agents used for treatment of inflammatory arthritis in children compared to adults

Oral phospholipidic curcumin in juvenile idiopathic arthritis-associated uveitis

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