How do you approach a patient with idiopathic anterior uveitis who has ongoing disease despite adalimumab every two weeks?
Answer from: at Community Practice
This is a style question, I think. I thought it would be useful to note the choice here might depend on testing for anti-adalimumab antibodies as there is some suggestion that changing to once weekly adalimumab in the presence of anti-adalimumab antibodies might not be efficacious. (Ismayilova et al...
I'd start by repeating the workup.
Rheum labs: CBC with Diff, ANA with cascade reflex, ANCA, ACE, Serum Lysozyme, Lyme, RPR, FT ABS, RF, quantiferon gold.
CXR. Consider PPD and HLA testing.
Re-evaluate the patient's systemic symptoms to see if they 'fit' a rheum syndrome even if antibodies negati...