{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:51:38Z","timestamp":1788184298883,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adalimumab (ADA) is an effective treatment for moderate to severe hidradenitis suppurativa (HS). However, nearly half of patients receiving the standard dose may lose response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To establish therapeutic thresholds for HS-specific ADA levels, leading to more personalized treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center, prospective observational study of adults with HS treated with ADA (40 or 80mg\/week, and 80mg\/biweekly) at a specialized HS clinic (January 2023\u2013May 2024). Serum samples were collected after \u22654 weeks of therapy to ensure steady state. Patients were stratified by physician-assessed response (low &amp;lt;50%, partial 50\u201375%, high &amp;gt;75% improvement). Associations of ADA concentration and clearance with response were tested using Spearman and Pearson correlations; discriminatory performance was evaluated with ROC analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 46 enrolled patients, the majority was female (60.9%) and White (54.3%), with a median age of 38 years (IQR: 30\u201345). ADA serum concentrations positively correlated with clinical response (r = 0.43, p = 0.002). Low responders had significantly lower concentrations than partial (p = 0.029) and high responders (p = 0.007). Clearance was inversely correlated with ADA levels (r = \u20130.65, p &amp;lt; 0.001). Receiver operating characteristic analysis identified optimal thresholds of 10.7 \u03bcg\/mL for ADA concentration and 0.5 L\/day for clearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher ADA concentrations and lower drug clearance are associated with better clinical outcomes in HS. ROC analysis identified 10.7 \u03bcg\/mL (ADA concentration) and 0.5 L\/day (clearance) as optimal cut-off values to differentiate low from partial\/high responders. These findings suggest that therapeutic drug monitoring may help optimize ADA therapy in HS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1760206","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:42:41Z","timestamp":1770295361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic drug monitoring of adalimumab in hidradenitis suppurativa: a prospective observational study"],"prefix":"10.3389","volume":"17","author":[{"given":"Stella X.","family":"Chen","sequence":"first","affiliation":[{"name":"Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Beth Israel Deaconess Medical Center","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Galvao de O.","family":"Wafae","sequence":"additional","affiliation":[{"name":"Clinical Laboratory for Epidemiology and Applied 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