Anti-Adalimumab Antibodies in Patients with Noninfectious Uveitis who Use Adalimumab Weekly or Every Other Week

Abstract

PurposeAdalimumab (ADA) is the only biologic agent approved for treating non-infectious uveitis (NIU). Anti-drug antibodies (AAA) may be an essential factor associated with treatment failure. We conducted a study to determine the clinical response to ADA treatment in patients with NIU. We also aimed to determine AAA's frequency and clinical importance in these patients.MethodsThis cross-sectional study included 60 NIU patients who used ADA therapy every other week or weekly for at least three months. The clinical findings recorded before starting ADA and on the day included in the study were compared. Serum AAA formation was evaluated. AAA-positive and AAA-negative patients were compared in terms of etiology, duration, and localization of uveitis, duration of ADA treatment, and additional IMT.ResultsThe increase in visual acuity, decrease in central macular thickness, improvement in the number of attacks/year, and decrease in need for CS were statistically significant with ADA treatment. AAA was positive in 15 (25%) patients. The improvement in median visual acuity, CMT, and number of attacks/year was statistically significant in both ADA-positive and negative patients. The effect of disease etiology, disease duration, uveitis localization, ADA treatment duration, and additional IMT use on serum AAA formation could not be demonstrated.ConclusionADA is mostly associated with favorable clinical response in treating NIU. In insufficient clinical response, the dose escalation method may increase treatment success. AAA formation may not be the only factor in the ineffectiveness of treatment.