Adalimumab and antibodies.
Patients with rheumatoid arthritis who develop high levels of serum antibodies against adalimumab have poor treatment response, according to a European study.
Antiadalimumab antibodies were found in 17% of patients with rheumatoid arthritis (RA) after 28 weeks of treatment, said Dr. Geertje M. Bartelds of the Jan van Breemen Institute, Amsterdam, and associates. The antibodies' presence was associated with diminished adalimumab concentrations, leading to diminished clinical response. The researchers noted the incidence of antiadalimumab antibody formation in a cohort of 121 RA patients. Most (79%) were female, and the mean age was 53 years (Ann. Rheum. Dis. 9 March 2007 [Epub doi:10.1136/ard.2006.065615]).
All of the patients met the American College of Rheumatology 1987 revised criteria for RA and had active disease despite previous treatment with disease-modifying antirheumatic drugs (DMARDs). They were treated with up to 40 mg adalimumab subcutaneously every other week, with or without a concomitant DMARD. Clinical response, serum adalimumab concentrations, and antibodies against adalimumab were noted after 28 weeks. There were 77 patients classified as responders according to the European League Against Rheumatism criteria. Of those, 34 were deemed good responders and 43 moderate responders. The mean improvement in disease activity score 28 (DAS28) was 1.7.
Antibodies to adalimumab were found in 21 (17%) patients. Significantly more EULAP, nonresponders had adalimumab antibodies than did good responders (34% vs. 5%, respectively). The presence of antibodies was also linked to less improvement in DAS28 score at 28 days, compared with those without antibodies (0.65 vs. 1.70).
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|Title Annotation:||Clinical Capsules|
|Publication:||Family Practice News|
|Article Type:||Brief article|
|Date:||May 15, 2007|
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