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Joint Bone Spine
Volume 83, n° 2
pages 167-171 (mars 2016)
Doi : 10.1016/j.jbspin.2015.04.020
accepted : 15 April 2015
The clinical relevance of early anti-adalimumab antibodies detection in rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: A prospective multicentre study
 

Ariela Hoxha a, , Antonia Calligaro a, Marta Tonello a, Roberta Ramonda a, Antonio Carletto b, Giuseppe Paolazzi c, Roberto Bortolotti c, Teresa Del Ross a, Chiara Grava d, Massimo Boaretto d, Maria Favaro a, Vera Teghil a, Amelia Ruffatti a, Leonardo Punzi a
a Rheumatology Unit, Department of Medicine, University of Padua, Via Giustiniani, 2-35128 Padova, Italy 
b Rheumatology Unit, Department of Medicine, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy 
c Rheumatology Unit, S. Chiara Hospital, Largo Medaglie D’oro, 9, 38122 Trento, Italy 
d Department of Medicine, S. Martino Hospital, Viale Europa, 22, 32100 Belluno, Italy 

Corresponding author.
Abstract
Objectives

To evaluate the relevance of anti-adalimumab (anti-ADA) antibodies (Abs) and their relationship with clinical/laboratory features in rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA).

Methods

Fifty-eight patients affected with RA, AS and PsA were prospectively enrolled. Clinical/laboratory characteristics, disease activity, anti-ADA, anti-nuclear (ANA), anti-double strand (ds)DNA, anti-extractable nuclear antigens (anti-ENA) and anti-phospholipid Abs (aPL) were evaluated at baseline, 4, 12 and 24 weeks of adalimumab treatment.

Results

Anti-ADA Abs were observed in 11/58 (19%) patients; they were detected within the 4th week of therapy in 90.9% of the positive subjects. Anti-ADA positivity was associated with significantly lower mean adalimumab serum levels (P <0.05). Treatment failure was observed in 20/58 (34.5%) patients and was significantly associated with anti-ADA Abs (P <0.05). Mean adalimumab serum levels were significantly lower in patients with treatment failure than in the responders one, both in the whole cohort (P <0.01) and in the group of anti-ADA positive patients (P <0.01). Adverse events happened more often in anti-ADA positive then in anti-ADA negative patients (27.3% vs 14.9%).

Conclusions

Anti-ADA abs could be considered an early marker associated to a poor clinical response to adalimumab treatment. Routine ANA/anti-ENA/aPL monitoring did not reveal as useful tools to predict the development of anti-ADA abs.

The full text of this article is available in PDF format.

Keywords : Anti-adalimumab antibodies, Rheumatoid arthritis, Ankylosing spondylitis, Psoriatic arthritis




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