AI Article Synopsis
- The study aimed to explore the formation of anti-drug antibodies (ADA) against infliximab (IFX) and how these relate to drug levels and patient outcomes in rheumatoid arthritis (RA) and spondyloarthritis (SpA).
- Serum samples were collected from 106 patients over time, and two different assays were used to detect ADA and measure IFX levels, with the drug-tolerant assay identifying ADA earlier than the drug-sensitive assay.
- Results showed that patients who developed ADA earlier had lower levels of IFX and shorter drug survival, suggesting early immunogenicity affects the treatment's effectiveness.
Article Abstract
Objectives: To investigate the appearance of anti-drug antibodies (ADA) against infliximab (IFX) determined by drug-sensitive and drug-tolerant assays and their relationship with drug levels and drug survival.
Methods: This longitudinal observational study included 45 patients with RA and 61 with SpA. Serum samples were obtained at weeks 2, 6, 12, 24 and 52. Serum IFX levels were measured by a capture ELISA and ADA by an in-house drug-sensitive two-site (bridging) ELISA (bELISA) and a commercially available drug-tolerant ELISA (IDK, Immundiagnostik, Germany).
Results: ADA were detected earlier by IDK than by bELISA. Once ADA appeared, positivity persisted throughout the study period. Patients who were bELISA ADA+ had higher IDK ADA levels (than bELISA ADA- patients). Circulating IFX levels were detected in all patients except those found to be bELISA ADA+. Serum IFX levels were lower in IDK ADA+ than in IDK ADA- patients. Most patients (64%) discontinued due to inefficacy. The early onset of immunogenicity was related to IFX survival. In both RA and SpA, the median survival (years) was shorter in patients with earlier development of ADA (IDK+ before or at week 24) than those who became IDK+ later (after week 24) or never developed ADA.
Conclusion: A drug-tolerant assay detects ADA during IFX therapy earlier and more frequently than a drug-sensitive assay. The onset of immunogenicity detected by drug-tolerant assays is related to the subsequent detection of ADA by drug-sensitive assays and drug survival.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701322 | PMC |
| http://dx.doi.org/10.1093/rheumatology/kead690 | DOI Listing |
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