The presence or absence of antibodies to infliximab or adalimumab determines the outcome of switching to etanercept

Abstract

Patients with RA with an immunogenic response against a first TNF-blocking agent had a better clinical response to a subsequent TNF blocker compared to patients with RA without anti-drug antibodies. Hence, determining immunogenicity can be helpful in deciding in which patient switching could be beneficial and can be part of a personalised treatment regimen.

Cytokines as Therapeutic Targets in Rheumatoid Arthritis and Other Inflammatory Diseases

“…There was also no statistically significant relationship between autoantibody titers and adverse clinical events in this study. Several studies indicated that the presence of antibodies against one TNF inhibitor does not preclude the use of another (van der Bijl et al, 2008;Bartelds et al, 2010;Jamnitski et al, 2011). In fact, the presence of anti-infliximab antibodies was associated with better response after switch to adalimumab or etanercept.…”

Detection of infliximab levels and anti‐infliximab antibodies: a comparison of three different assays

“…This may result in poor specificity, sensitivity and reproducibility. In this study, we determined the correlation between academically developed assays (Leuven and Amsterdam) that were used in several studies to detect IFX drug levels and anti-IFX antibodies [17][18][19] and are routinely applied in patient diagnostics, and a commercially available assay (further referred to as BMD ELISA) used in the study of Pariente et al A total of 62 samples were analysed by all three institutes. Thirty six samples were clinical samples from patients containing different concentrations of IFX and ATI.…”

Viewpoint on handling anti-TNF failure in psoriasis

“…Findings in RA patients suggest that the absence of ADAs in non-responders might reflect a lack of responsiveness to the mechanism of action shared by all anti-TNF agents and indicates the need to switch to a drug with a different mechanism of action [3,11]. Accordingly, in patient 1 and 2, a switch to ustekinumab would be recommended (see Combining the results of trough serum drug levels (TSDLs) and anti-drug antibodies (ADAs) results in the following options: if the TSDLs are low, and no ADAs are detected, it is firstly important to ensure a good adherence.…”

“…Based on the literature, a switch to another TNF antagonist can be efficacious in such cases, as ADAs do not crossreact [3,11,16] (Fig. 1a).…”