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  • Open Access

PReS-FINAL-2274: Antiadalimumab antibodies in pediatric rheumatology patients. A pilot experience

  • S Murias Loza1,
  • RM Alcobendas Rueda1,
  • A Remesal Camba1,
  • D Pascual Salcedo2,
  • J Peralta3 and
  • R Merino Muñoz1
Pediatric Rheumatology201311(Suppl 2):P264

https://doi.org/10.1186/1546-0096-11-S2-P264

Published: 5 December 2013

Keywords

Visual Analogue ScaleUveitisAdalimumabMedian Survival TimePilot Experience

Introduction

Immunogenicity of anti-Tumor Necrosis Factor agents is one of the mechanisms behind treatment failure.

Objectives

To explore the relationship between the presence of antiadalimumab antibodies (AAA), the disease activity and the therapeutic decisions.

Methods

Cross-sectional retrospective study determining: 1) serum adalimumab (Ada) levels by a capture ELISA (positive > 5 ng/ml) and 2) levels of AAA by a two-site bridging ELISA [positive > 10 Arbitrary Units (AU)/ml]. The clinical activity was assessed by conventional tests and the physician visual analogue scale (ph-VAS) of 0 to 10, the same day that the blood sample was collected. Blood samples were obtained a few hours before drug administration.

Results

Until March 2013 measurements in 25 patients were available, 15 (60%) of them had some activity of their disease ph-VAS = 1.7 ± 0.9 (1-4). Eight (32%) children presented AAA, range from 12 to 30,000 AU/ml, and absence of Ada levels. All cases with AAA positives had active disease, except one who had received a periocular corticosteroid injection in the previous month. Furthermore 8/17 (47%) patients without AAA had active disease. The duration disease and the age were not different between those with and without AAA. The only clinical and analytical difference was the higher frequency of active uveitis when AAA were present (p = 0.01). Similarly median survival time on treatment was shorter when AAA were present (2.3 vs 2.5 years) (p = 0.03).

Conclusion

Antiadalimumab antibodies appear to explain half of the cases of active disease and their presence is associated with discontinuation of treatment.

Disclosure of interest

None declared.
Table 1

Characteristics of 25 children with pediatric rheumatic diseases treated with Adalimumab.

AAA

Girls

JIA

ANA+

Uveitis

Active uveitis

Active

arthritis

MTX

Drug switching

Present

n = 8

6 (75)

4 (50)

4 (50)

8 (100)

6 (75)

2 (25)

2 (25)

4 (50)

Absent

n = 17

13 (77)

15 (88)

6 (35)

13 (77)

3 (18)

5 (29)

6 (35)

4 (24)

Data are expressed as n (%)

AAA = Antiadalimumab antibodies; JIA = Juvenile Idiopathic Arthritis; ANA = Antinuclear antibodies; MTX = Concomitant Methotrexate.

Authors’ Affiliations

(1)
Pediatric Rheumatology, Hospital Universitario La Paz, Madrid, Spain
(2)
Immunology, Hospital Universitario La Paz, Madrid, Spain
(3)
Ophthalmology, Hospital Universitario La Paz, Madrid, Spain

Copyright

© Murias Loza et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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