Adalimumab in the treatment of pediatric patients with chronic noninfectious anterior uveitis

Introduction: Adalimumab is established as an effective treatment for pediatric noninfectious uveitis refractory to methotrexate. However current use of the medication is empiric, according to fixed-dosing regimens and a significant proportion of patients will be nonresponsive or suboptimally responsive to adalimumab. Areas covered: There remains considerable scope to improve outcomes through tailoring treatment according to individual patient responsiveness. Monitoring of anti-drug antibodies and serum drug trough levels may assist in predicting which patients are likely to have a poor response to adalimumab and enable tailoring of regimens to individual patients. Expert opinion: We propose use of these biomarkers to individualize therapy in suboptimally responding patients, and present an algorithm of treatment escalation for pediatric noninfectious uveitis.

Automated summary

Adalimumab is effective for treating pediatric noninfectious uveitis refractory to methotrexate, but current use is empirical. Monitoring antibodies and drug levels can help predict poor responses and customize treatment, leading to improved outcomes.