EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY

Objective: to assess the relationship of the efficiency of adalimumab (ADA) therapy in early rheumatoid arthritis (RA) with the serum level of the drug and with the presence of antibody (Ab) to it.Subjects and methods. Serum concentration of ADA and Ab against it (μg/ml) were measured using an enzym...

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Main Authors: A. S. Avdeeva, E. N. Aleksandrova, D. E. Karateev, E. L. Luchikhina, A. A. Novikov, M. V. Cherkasova, E. L. Nasonov
Format: Article
Language:Russian
Published: IMA PRESS LLC 2014-12-01
Series:Научно-практическая ревматология
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Online Access:https://rsp.mediar-press.net/rsp/article/view/2007
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author A. S. Avdeeva
E. N. Aleksandrova
D. E. Karateev
E. L. Luchikhina
A. A. Novikov
M. V. Cherkasova
E. L. Nasonov
author_facet A. S. Avdeeva
E. N. Aleksandrova
D. E. Karateev
E. L. Luchikhina
A. A. Novikov
M. V. Cherkasova
E. L. Nasonov
author_sort A. S. Avdeeva
collection DOAJ
description Objective: to assess the relationship of the efficiency of adalimumab (ADA) therapy in early rheumatoid arthritis (RA) with the serum level of the drug and with the presence of antibody (Ab) to it.Subjects and methods. Serum concentration of ADA and Ab against it (μg/ml) were measured using an enzyme immunoassay in 25 patients with early RA before, 12 and 24 weeks after beginning of the therapy. All patients received the disease-modifying antirheumatic drug methotrexate and ADA 40 mg subcutaneously every other week. ADA was the first biological agent for all patients.Results. The patients were divided into the following groups: those with a serum ADA level of <2.85 (Group 1, n=7) and ≥2.85 (Group 2, n=13). After 24 weeks of treatment, Group 1 showed higher disease activity (DAS was 4.5 [3.3; 4.9]) and levels of acute-phase reactants (ESR, 44 [18; 57] mm/hr; C-reactive protein (CRP), 10.1 [4.9; 34.5] mg/ml) than Group 2 (3.5 [2.9; 3.9], 15.0 [6.0; 17.0] mm/hr, 1.9 [0.75; 6.7] mg/ml, respectively; p<0.05). Also, after24 weeks of therapy, there was a negative correlation of ADA level and DAS28 (r=-0.46; p=0.04), CRP (r=-0.54;p=0.02) and ESR (r=-0.5; p=0.02). Anti-ADA Ab were found in 3 and 2 patients after 12 and 24 weeks, respectively. After 24 weeks of therapy, allpatients with anti-ADA Ab exhibited no clinical effect. There were few unresponsive patients (11%) among those without anti-ADA Ab.Conclusion. In patients with early RA treated with ADA, its low serum level (<2.85 μg/ml) is associated with the higher clinical and laboratory measures of disease activity. After 12–24 weeks of ADA therapy, 10–12.5% of patients are found to have Ab to the drug and its production is associated with lower efficacy.
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spelling doaj-art-67a0dc0fbc444bee972eaa4f4c3727402025-08-20T03:38:11ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922014-12-0152662463010.14412/1995-4484-2014-624-6301926EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODYA. S. Avdeeva0E. N. Aleksandrova1D. E. Karateev2E. L. Luchikhina3A. A. Novikov4M. V. Cherkasova5E. L. Nasonov6V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522Objective: to assess the relationship of the efficiency of adalimumab (ADA) therapy in early rheumatoid arthritis (RA) with the serum level of the drug and with the presence of antibody (Ab) to it.Subjects and methods. Serum concentration of ADA and Ab against it (μg/ml) were measured using an enzyme immunoassay in 25 patients with early RA before, 12 and 24 weeks after beginning of the therapy. All patients received the disease-modifying antirheumatic drug methotrexate and ADA 40 mg subcutaneously every other week. ADA was the first biological agent for all patients.Results. The patients were divided into the following groups: those with a serum ADA level of <2.85 (Group 1, n=7) and ≥2.85 (Group 2, n=13). After 24 weeks of treatment, Group 1 showed higher disease activity (DAS was 4.5 [3.3; 4.9]) and levels of acute-phase reactants (ESR, 44 [18; 57] mm/hr; C-reactive protein (CRP), 10.1 [4.9; 34.5] mg/ml) than Group 2 (3.5 [2.9; 3.9], 15.0 [6.0; 17.0] mm/hr, 1.9 [0.75; 6.7] mg/ml, respectively; p<0.05). Also, after24 weeks of therapy, there was a negative correlation of ADA level and DAS28 (r=-0.46; p=0.04), CRP (r=-0.54;p=0.02) and ESR (r=-0.5; p=0.02). Anti-ADA Ab were found in 3 and 2 patients after 12 and 24 weeks, respectively. After 24 weeks of therapy, allpatients with anti-ADA Ab exhibited no clinical effect. There were few unresponsive patients (11%) among those without anti-ADA Ab.Conclusion. In patients with early RA treated with ADA, its low serum level (<2.85 μg/ml) is associated with the higher clinical and laboratory measures of disease activity. After 12–24 weeks of ADA therapy, 10–12.5% of patients are found to have Ab to the drug and its production is associated with lower efficacy.https://rsp.mediar-press.net/rsp/article/view/2007rheumatoid arthritisadalimumabserum drug levelanti-adalimumab antibodytreatment efficacy
spellingShingle A. S. Avdeeva
E. N. Aleksandrova
D. E. Karateev
E. L. Luchikhina
A. A. Novikov
M. V. Cherkasova
E. L. Nasonov
EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
Научно-практическая ревматология
rheumatoid arthritis
adalimumab
serum drug level
anti-adalimumab antibody
treatment efficacy
title EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
title_full EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
title_fullStr EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
title_full_unstemmed EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
title_short EFFICACY OF ADALIMUMAB IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO ITS SERUM LEVEL AND THE PRESENCE OF ANTI-DRUG ANTIBODY
title_sort efficacy of adalimumab in early rheumatoid arthritis in relation to its serum level and the presence of anti drug antibody
topic rheumatoid arthritis
adalimumab
serum drug level
anti-adalimumab antibody
treatment efficacy
url https://rsp.mediar-press.net/rsp/article/view/2007
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