In this retrospective case-control study, Elaraby et al (p. 1185) investigated the potential impact of ocular inflammation on development of anti-adalimumab antibodies (AAAs) in patients with autoimmune diseases treated with adalimumab. Analysis of 704 enrolled patients found AAAs in 151 patients (21.5%). Ocular inflammation, female sex, and adalimumab interruption were independently associated with higher odds of positive AAA findings. Prior exposure to other tumor necrosis factor inhibitors did not reduce the likelihood of AAA formation, but prior treatment with biologics targeting non-TNF pathways was associated with a significantly lower risk of AAA development.