Early monitoring of anti-infliximab antibodies by drug-tolerant assay predicts later immunogenicity and drug survival in rheumatic diseases
Authors' 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.
Study context
- Population
- Patients with RA or SpA treated with infliximab (IFX); serum samples at weeks 2, 6, 12, 24 and 52
- Participants
- 45 vs 61
- Exposure
- Drug-tolerant ELISA vs drug-sensitive bridging ELISA for ADA against IFX
- RAn = 45
- SpAn = 61
- Outcome
- Appearance of ADA against IFX by drug-sensitive and drug-tolerant assays and their relationship with drug levels and drug survival
Methodological detailslongitudinal observational
- Longitudinal observational
Main finding
As reported in the abstract
ADA detection, IFX levels and drug survival
- ADA detected earlier by IDK than by bELISA
- Once ADA appeared, positivity persisted throughout the study period
- bELISA ADA+ patients had higher IDK ADA levels than bELISA ADA- patients
- Circulating IFX detected in all patients except bELISA ADA+
- Serum IFX levels lower in IDK ADA+ than IDK ADA- patients
- In RA and SpA, median survival shorter with ADA (IDK+) at or before week 24 than IDK+ after week 24 or never ADA
Observational data: associations, not effects.
Further findings
Discontinuation due to inefficacy
- Most patients discontinued due to inefficacy
- 64%
Original publication
Early monitoring of anti-infliximab antibodies by drug-tolerant assay predicts later immunogenicity and drug survival in rheumatic diseases. Rheumatology (Oxford). Published 4 January 2024. doi:10.
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