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

Abstract：

OBJECTIVE:The aim of this study was to test the hypothesis that the reason for non-response (caused by immunogenicity or not) to a first tumour necrosis factor (TNF) inhibitor defines whether a second TNF inhibitor will be effective. METHODS:This cohort study consisted of 292 consecutive patients with rheumatoid arthritis (RA), all treated with etanercept. A total of 89 patients (30%) were treated previously with infliximab or adalimumab ('switchers'), and the remaining 203 (70%) were anti-TNF naive. All switchers were divided into two groups: with and without antibodies against the previous biological. Differences in clinical response to etanercept between switchers with and without antibodies and patients who were anti-TNF naive were assessed after 28 weeks of treatment using changes in Disease Activity Score in 28 joints (DAS28). RESULTS:After 28 weeks of treatment, response to etanercept did not differ between patients who were anti-TNF naive and switchers with anti-drug antibodies (ΔDAS28=2.1 ± 1.3 vs ΔDAS28=2.0 ± 1.3; p = 0.743). In contrast, switchers without anti-drug antibodies had a diminished response to etanercept treatment compared to patients who were TNF naive (ΔDAS28 =1.2±1.3 vs ΔDAS28 = 2.1 ± 1.3; p = 0.001) and switchers with antibodies (ΔDAS28 =1.2±1.3 vs ΔDAS28 = 2.0 ± 1.3; p = 0.017). CONCLUSION: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.

journal_name

Ann Rheum Dis

journal_title

Annals of the rheumatic diseases

authors

Jamnitski A,Bartelds GM,Nurmohamed MT,van Schouwenburg PA,van Schaardenburg D,Stapel SO,Dijkmans BA,Aarden L,Wolbink GJ

doi

10.1136/ard.2010.135111

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

284-8

issue

eissn

0003-4967

issn

1468-2060

pii

ard.2010.135111

journal_volume

pub_type

临床试验,杂志文章

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