Drug-induced neutralizing antibodies against tumor necrosis factor-α (TNF-α) inhibitor negatively affect the course of inflammatory joint disease and can be considered a reliable biomarker to gauge the effectiveness of therapy, according to a study published in the journal Folia Medica.
“In recent years, particular attention has been paid to the formation of neutralizing antibodies in the patient’s body during treatment with biologics, since, according to some authors, their infusion leads to a decrease or no effect of the applied therapy,” the researchers explained. “Despite numerous studies on this topic and the widespread recognition of the presence of drug-induced neutralizing antibodies against TNF-α blocking drugs, there is still no clear opinion what their impact on the course of the disease is.”
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To investigate the effect of neutralizing antibodies against TNF-α inhibitors on the clinical course of the disease, the researchers monitored 121 patients with rheumatoid arthritis, 50 patients with ankylosing spondylitis, 42 patients with psoriatic arthritis, and 31 sex- and age-matched healthy controls at 6, 12, and 24 months after initiation of TNF-α therapies.
In patients treated with adalimumab, drug-induced neutralizing antibodies were found in 11.57% of patients at 6 months, 17.64% of patients at 12 months, and 24.8% of patients at 24 months. In patients treated with etanercept, no drug-induced neutralizing antibodies were found in patients at 6 months, but they were found in 7.77% of patients at 12 months and in 9.63% of patients at 24 months.
Among patients with drug-induced neutralizing antibodies to adalimumab and etanercept, the researchers found the clinical response at 6, 12, and 24 months was significantly worse.
They found that 82.36% of patients with available antibodies against adalimumab and 71.42% of patients with available antibodies against etanercept at 12 months showed poor clinical response. In addition, 75% of patients treated with adalimumab had poor clinical response and available antibodies at 24 months, while 87.50% of patients treated with etanercept showed poor clinical response and available antibodies.
Kraev K, Geneva-Popova M, Popova V, et al. Drug-neutralizing antibodies against TNF-α blockers as biomarkers of therapy effect evaluation. Folia Med (Plovdiv). 2020;62(2):282-289. doi:10.3897/folmed.62.e39402