TNF alpha blockers like infliximab (IFX) and adalimumab (ADA) are effective for inflammatory diseases but about 30% of patients don't respond, possibly due to anti-drug antibodies (ADAbs).
A study involving 197 patients found that 40% of those on IFX and 25% on ADA tested positive for ADAbs, with varying rates across conditions (RA, SpA, and CD).
Despite the presence of ADAbs being linked to lower drug levels, they did not correlate with disease activity, suggesting that other factors besides immunogenicity may influence treatment failures.
Brucellosis is a zoonosis that affects several organs. The spine is the most common site of musculoskeletal involvement. However, multiple-level spinal involvement is rare in brucella spondylodiscitis.