{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:04:03Z","timestamp":1790071443372,"version":"4.0.1"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,3,4]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adalimumab is an effective first-line biologic therapy used to treat children and young people (CYP) with juvenile idiopathic arthritis (JIA) and non-infectious uveitis (NIU). However, the development of neutralising antibodies may compromise adalimumab\u2019s efficacy. This study investigated the incidence and clinical relevance of anti-adalimumab antibody (AAA) development in CYP treated with adalimumab for JIA and\/or NIU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted within a specialist paediatric rheumatology service at a tertiary UK centre. CYPs receiving adalimumab between January 2015 and January 2024 who were tested for AAAs were included. Outcome measures included AAA positivity rate, serum drug levels, concurrent disease-modifying anti-rheumatic drug (DMARD) use, timing of antibody development and patient outcomes following AAA results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 390 CYP treated with adalimumab, 112 were tested for AAAs (156 total tests). Overall, 41.0% were AAA positive (&gt;10 mg\/L). All CYP with sub-therapeutic drug levels (&lt;3 mg\/L) were AAA positive. AAA positivity was higher in CYP not receiving concurrent DMARDs (52.4%) compared with those receiving full-dose methotrexate (21.1%) (OR 4.12, p=0.002). Among AAA-positive patients, 53.1% discontinued adalimumab treatment versus 15.2% of AAA-negative patients (OR 6.3, p&lt;0.0001). Serial testing revealed fluctuating AAA levels, including reductions following corticosteroid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High AAA incidence was observed in CYP with JIA and NIU, with most tested during disease flare. AAA positivity correlated with sub-therapeutic drug levels and treatment discontinuation, particularly in the absence of concurrent full-dose methotrexate. Short-term variability in antibody titres suggests that a single positive result may not reliably indicate treatment failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328938","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T17:20:19Z","timestamp":1773940819000},"page":"1164-1170","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Single-centre observational study of anti-adalimumab antibody development in children and young people treated for juvenile idiopathic arthritis and\/or non-infectious uveitis"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0328-436X","authenticated-orcid":false,"given":"Charlotte Rose","family":"Wilson","sequence":"first","affiliation":[{"name":"Sheffield Children\u2019s Hospital NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott Robert","family":"Somerville","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P","family":"Hawley","sequence":"additional","affiliation":[{"name":"Rheumatology, Sheffield Children\u2019s Hospital NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessy","family":"Choi","sequence":"additional","affiliation":[{"name":"Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"Ophthalmology, Sheffield Children\u2019s Hospital NHS Foundation Trust, Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"2026092202200731000_110.10.1164.1","first-page":"85","article-title":"Role of adalimumab in the management of children and adolescents with juvenile idiopathic arthritis and other rheumatic conditions","volume":"3","author":"Marzan","year":"2012","journal-title":"Adolesc Health Med Ther"},{"key":"2026092202200731000_110.10.1164.2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5114\/reum.2020.100169","article-title":"Uveitis associated juvenile idiopathic arthritis - presentation of recently published international recommendations for diagnostic and therapeutic procedures","volume":"58","author":"Rutkowska-Sak","year":"2020","journal-title":"Reumatologia"},{"key":"2026092202200731000_110.10.1164.3","doi-asserted-by":"publisher","DOI":"10.1002\/path.2287"},{"key":"2026092202200731000_110.10.1164.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2007.10.001"},{"key":"2026092202200731000_110.10.1164.5","unstructured":"National Institute for Health and Care Excellence . Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis. NICE Guidelines; 2015. Available: www.nice.org.uk\/guidance\/ta373"},{"key":"2026092202200731000_110.10.1164.6","unstructured":"National Institute for Health and Care Excellence . Adalimumab and dexamethasone for treating non-infectious uveitis. NICE Guidelines; 2017. Available: www.nice.org.uk\/guidance\/ta460"},{"key":"2026092202200731000_110.10.1164.7","doi-asserted-by":"crossref","unstructured":"Ramanan AV , Dick AD , Jones AP , et al . n.d. Adalimumab in combination with methotrexate for refractory uveitis associated with juvenile idiopathic arthritis: a RCT. Health Technol Assess 23:1\u2013140. doi:10.3310\/hta23150","DOI":"10.3310\/hta23150"},{"key":"2026092202200731000_110.10.1164.8","doi-asserted-by":"crossref","first-page":"2618","DOI":"10.1016\/j.ophtha.2016.08.025","article-title":"Adalimumab for Treatment of Noninfectious Uveitis: Immunogenicity and Clinical Relevance of Measuring Serum Drug Levels and Antidrug Antibodies","volume":"123","author":"Cordero-Coma","year":"2016","journal-title":"Ophthalmology [Internet]"},{"key":"2026092202200731000_110.10.1164.9","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12093271","article-title":"Anti-Drug Antibodies in the Biological Therapy of Autoimmune Rheumatic Diseases","volume":"12","author":"Pizano-Martinez","year":"2023","journal-title":"J Clin Med"},{"key":"2026092202200731000_110.10.1164.10","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1080\/09273948.2023.2256850","article-title":"Immunogenicity of Adalimumab in Patients with Non-Infectious Uveitis: Systematic Review and 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