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Influence of neutralizing antibodies to adalimumab and infliximab on the treatment of psoriasis
Author(s) -
Bito T.,
Nishikawa R.,
Hatakeyama M.,
Kikusawa A.,
Kanki H.,
Nagai H.,
Sarayama Y.,
Ikeda T.,
Yoshizaki H.,
Seto H.,
Adachi A.,
Horikawa T.,
Oka M.,
Nishigori C.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12791
Subject(s) - adalimumab , medicine , infliximab , psoriasis , regimen , psoriasis area and severity index , therapeutic drug monitoring , gastroenterology , dermatology , immunology , tumor necrosis factor alpha , pharmacokinetics
Summary Background Current treatment with biologics has produced dramatic therapeutic effects in patients with psoriasis, although these agents occasionally decrease in efficacy. One of the main factors responsible for this attenuation is attributed to the development of antidrug antibodies ( ADA s). Objectives To analyse the relationship between serum drug concentrations, the presence of ADA s and treatment efficacy of adalimumab and infliximab, and to determine the optimal use of these biologics. Methods This was a 1‐year prospective study in the dermatology departments of K obe U niversity H ospital and collaborating hospitals. All patients starting a regimen of adalimumab and infliximab for psoriasis were included. We measured the serum concentration of the drugs and titres of antibodies to adalimumab and infliximab, as well as the P soriasis A rea and S everity I ndex scores at weeks 0, 4, 12, 24 and 48 during the first year of treatment. Results We observed a 50% positive rate of ADA s to adalimumab, and a 41% positive rate of ADA s to infliximab. The titres of ADA s showed a wide range from low to high titres. In the high‐titre groups, the patients exhibited a decreased clinical response, and demonstrated a negative correlation between titre and clinical response. However, an equivalent therapeutic effect was observed between the low‐titre group and the group with no antibodies detected for adalimumab. For infliximab, the patients with ADA s showed decreased clinical response. An apparent negative correlation between antibody production and reduced clinical response was observed. Conclusions Two biologics, adalimumab and infliximab, showed different therapeutic behaviour. The measurement of ADA s and drug concentrations has important implications for treatment with biologics.