Non-trough adalimumab and certolizumab drug levels associated with a therapeutic EULAR response in adherent patients with rheumatoid arthritis
Authors' conclusion
In fully adherent patients, higher SDLs are detected in good responders, suggesting that interventions to improve SDLs, such as encouraging adherence, could improve treatment response.
Study context
- Population
- Patients with RA treated with adalimumab or certolizumab; fully adherent patients analysed as a subgroup
- Participants
- 475 patients
- Exposure
- Serum drug levels in EULAR good vs non-/moderate responders, adalimumab and certolizumab
- Adalimumabn = 283
- Certolizumabn = 192
- Outcome
- Relationship between adalimumab/certolizumab serum drug levels (SDLs) and EULAR good vs non-/moderate response; SDL cut-offs associated with good response in fully adherent patients
Methodological detailsROC analysis, fully adherent subgroup
- ROC analysis
- Fully adherent subgroup
Main finding
As reported in the abstract
Median SDLs, good vs non-/moderate responders (fully adherent); 3-month non-trough SDL ROC discrimination · 3 months (ROC)
| Group | AUC | Cut-off | Specificity | Sensitivity |
|---|---|---|---|---|
| Adalimumab | 0.63 (95% CI 0.52, 0.75) | 7.5 mg/l | 39.1% | 80.9% |
| Certolizumab | 0.65 (95% CI 0.51, 0.78) | 26.0 mg/l | 43.9% | 77.8% |
AUC
Adalimumab0.63 (95% CI 0.52, 0.75)
Certolizumab0.65 (95% CI 0.51, 0.78)
Cut-off
Adalimumab7.5 mg/l
Certolizumab26.0 mg/l
Specificity
Adalimumab39.1%
Certolizumab43.9%
Sensitivity
Adalimumab80.9%
Certolizumab77.8%
- Good responders vs Non-/moderate responders: P = 0.04 — significantly higher in fully adherent good responders
- Good responders vs Non-/moderate responders: P = 0.0005 — significantly higher in fully adherent good responders
Observational data: associations, not effects.
Original publication
Non-trough adalimumab and certolizumab drug levels associated with a therapeutic EULAR response in adherent patients with rheumatoid arthritis. Rheumatology (Oxford). Published 3 October 2022. doi:10.
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