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Association of adalimumab trough concentrations and treatment response in patients with juvenile idiopathic arthritis

Martijn J H Doeleman1,2, Sytze de Roock1,2, Mohsin El Amrani2,3

  • 1Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.

Rheumatology (Oxford, England)
|April 20, 2021
PubMed

Insights

Lower adalimumab trough concentrations in pediatric patients with juvenile idiopathic arthritis (JIA) correlate with secondary treatment failure. Monitoring drug levels can help optimize adalimumab dosing for better therapeutic outcomes.

Area of Science:

  • Immunology
  • Pharmacology
  • Pediatric Rheumatology

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease affecting children.
  • Adalimumab is a biologic therapy used for JIA, but treatment response can vary.
  • Understanding factors influencing adalimumab efficacy is crucial for optimizing patient care.

Purpose of the Study:

  • To investigate the association between adalimumab trough concentrations and treatment response in pediatric patients diagnosed with JIA.
  • To determine if adalimumab levels can predict treatment outcomes in this population.

Main Methods:

  • A monocentric cohort study involving pediatric JIA patients treated with adalimumab.
  • Quantification of adalimumab trough concentrations using liquid chromatography-tandem mass spectrometry.
  • Assessment of disease activity via the clinical Juvenile Arthritis Disease Activity Score with 71-joint count (cJADAS71).

Main Results:

  • Thirty-five adalimumab trough samples from 34 pediatric JIA patients were analyzed.
  • Significantly lower adalimumab trough concentrations were observed in patients experiencing secondary treatment failure compared to those with primary failure or adequate response.
  • No significant difference in adalimumab dosage was noted between groups, highlighting concentration as a key factor.

Conclusions:

  • Adalimumab trough concentrations are significantly lower in JIA patients with secondary failure.
  • Therapeutic drug monitoring of adalimumab trough levels may identify patients needing dose adjustments to achieve optimal therapeutic concentrations.
  • This approach can aid in optimizing adalimumab treatment strategies for pediatric JIA.
Abstract

Keywords:
LC–MS/MSadalimumabjuvenile idiopathic arthritistherapeutic drug monitoring

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