adalimumab (9MW0113 / UBP 1211 / UBP1211)

Evaluation of monocyte indices as predictors of adalimumab response in patients with psoriasis: A retrospective real-world data study.

Krogh-Jensen Ole O, Loft Nikolai N, Kaur-Knudsen Diljit D, Zachariae Claus C et al.

Leucine-rich alpha-2 glycoprotein as a predictor of primary non-response to anti-TNF-α therapy in biologic-naïve Egyptian IBD patients.

Amer Ibrahiem I, El Batae Hassan H, Elshaer Yasmine A YA, Sherief Dalia Elsayed DE et al.

Anti-tumor necrosis factor-α (anti-TNF-α) agents are a cornerstone in inflammatory bowel disease (IBD) therapy, yet primary non-response remains a significant practical challenge. Leucine-rich alpha-2 glycoprotein (LRG) has been recognized as a promising marker for disease activity. This study aimed to evaluate the predictive significance of pre-treatment serum LRG for response to anti-TNF-α therapy in biologic-naïve Egyptian IBD patients. In this prospective cohort study, 100 biologic-naïve IBD adult patients (50 Crohn's disease [CD], 50 ulcerative colitis [UC]) and 100 healthy controls were enrolled. Patients received induction therapy with adalimumab or infliximab. Clinical, biochemical, and endoscopic evaluations were conducted at baseline and at week 24. Response was defined by clinical indices and endoscopic improvement, while biochemical normalization was evaluated as a secondary, supportive parameter. IBD patients had significantly elevated baseline LRG levels compared to the healthy controls (p < 0.001). Responders' baseline LRG was substantially lower than that of non-responders in both UC (26.53 vs. 34.88 µg/mL; p = 0.008) and CD (26.03 vs. 35.07 µg/mL; p = 0.006). Receiver operating characteristic analysis revealed a cut-off of > 29 µg/mL for predicting non-response, yielding sensitivities of 74.2% and 80.0% with specificities of 69.57% and 65.71% for UC and CD, respectively and negative predictive values of 85.7% for UC and 88.5% for CD. Multivariate regression confirmed baseline LRG as an independent predictor of non-response. Baseline serum LRG levels > 29 µg/mL demonstrated moderate discriminatory ability for predicting primary non-response to anti-TNF-α therapy in Egyptian IBD patients. LRG may serve as a useful adjunctive biomarker for pre-treatment risk estimation and recognizing patients who may require alternative therapeutic strategies.

Legionella Myocarditis with Reversible Left Ventricular Dysfunction in a Patient Receiving Adalimumab: A Case Report.

Alzubi Alhasan Saleh AS, Shelig Mohamed M, Hegazy Yasser Y, Alagha Zakaria Z et al.

Legionella pneumophila is a well-recognized cause of community-acquired pneumonia, but its capacity to cause extrapulmonary complications, including myocarditis, remains underappreciated. Myocarditis is among the rarest and most serious cardiac manifestations of Legionella infection and may be underdiagnosed in critically ill patients, where troponin elevations are often attributed to sepsis-related myocardial injury. We report the case of a 51-year-old woman with diabetes mellitus, ulcerative colitis managed with adalimumab (a tumor necrosis factor-α inhibitor), and a significant smoking history who presented to the emergency department after being found unresponsive. She was febrile, tachycardic, and in respiratory distress, with laboratory findings significant for markedly elevated troponin (7,377 ng/L), creatine kinase (10,561 U/L), and procalcitonin (27 ng/mL). Echocardiography revealed severe left ventricular systolic dysfunction with an ejection fraction of less than 15%. A urine antigen test confirmed Legionella pneumonia. Hemodynamic assessment using the Fick method excluded cardiogenic shock, and left heart catheterization demonstrated no obstructive coronary artery disease. Following a 14-day course of levofloxacin along with supportive care, her cardiac function recovered completely, with a follow-up ejection fraction of 71%. This case highlights the potential for Legionella infection to cause fulminant yet fully reversible myocarditis and underscores the role of TNF-α inhibitor therapy as a predisposing factor for severe Legionella disease. Clinicians should maintain a high index of suspicion for myocarditis in patients with Legionella pneumonia who present with unexplained troponin elevation and new systolic dysfunction, as early recognition and targeted antimicrobial therapy can lead to complete cardiac recovery.

Real-World Treatment Response to Adalimumab and Secukinumab in Chinese Adults with Hidradenitis Suppurativa: A Retrospective Cohort Study.

du Yanyu Y, Zhan Jipang J, He Renliang R, Zhang Lian L

Biologic therapies have transformed the management of moderate-to-severe hidradenitis suppurativa (HS). However, real-world comparative data between tumor necrosis factor-alpha (TNF-α) inhibitors and interleukin-17 (IL-17) inhibitors in Chinese populations remain limited. To compare the short- and mid-term effectiveness and safety of TNF-α versus IL-17 inhibitors in adult Chinese patients with HS. This single-center retrospective cohort study included adult patients (≥18 years) with moderate-to-severe HS treated with biologics. Patients were stratified into TNF-α inhibitor and IL-17 inhibitor groups. The primary endpoint was achievement of Hidradenitis Suppurativa Clinical Response (HiSCR50) at week 16. Secondary endpoints included HiSCR50 at weeks 12, and safety outcomes. A total of 79 adult patients were included (TNF-α: n=25; IL-17: n=54). At week 12, response rates remained similar (72.0% vs. 63.0%). By week 16, a decline in response was observed in the TNF-α group (56.0%), whereas the IL-17 group maintained a stable response (66.7%). Safety profiles were acceptable in both groups, with one discontinuation due to fungal infection in the IL-17 group. Both TNF-α and IL-17 inhibitors demonstrate rapid onset of action in HS. However, IL-17 inhibitors may offer superior mid-term durability of response, supporting their role as a preferred option for sustained disease control.