The formation of autoantibodies and antibodies to TNF-α blocking agents in relation to clinical response in patients with ankylosing spondylitis.

Abstract

OBJECTIVES:

To investigate the influence of antibody formation to TNF-α blocking agents on the clinical response in AS patients treated with infliximab (IFX), etanercept (ETA), or adalimumab (ADA), and to investigate the development of ANA, ANCA, and anti-dsDNA antibodies in association with the formation of antibodies to TNF-α blocking agents.

METHODS:

Consecutive AS outpatients with active disease who started treatment with IFX (n=20), ETA (n=20), or ADA (n=20) were included in this longitudinal observational study. Clinical data were collected prospectively at baseline and after 3, 6, and 12 months of anti-TNF-α treatment. At the same time points, serum samples were collected. In these samples, antibodies to TNF-α blocking agents, serum TNF-α blocker levels, and ANA, ANCA, and anti-dsDNA antibodies were measured retrospectively.

RESULTS:

Anti-IFX, anti-ETA, and anti-ADA antibodies were induced in 20%, 0%, and 30% of patients, respectively. Although ANA, ANCA, and anti-dsDNA antibodies were detected during anti-TNF-α treatment, no significant association was found between the presence of these autoantibodies and the formation of antibodies to TNF-α blocking agents. Patients with anti-IFX or anti-ADA antibodies had significantly lower serum TNF-α blocker levels compared to patients without these antibodies. Furthermore, significant negative correlations were found between serum TNF-α blocker levels and assessments of disease activity.

CONCLUSIONS:

This study indicates that antibody formation to IFX or ADA is related to a decrease in efficacy and early discontinuation of anti-TNF-α treatment in AS patients. Furthermore, autoantibody formation does not seem to be associated with antibody formation to TNF-α blocking agents.

• Authors: S Arends, H R Lebbink, A Spoorenberg, L B Bungener, C Roozendaal, E van der Veer, P M Houtman, E N Griep, P C Limburg, C G M Kallenberg, G J Wolbink, E Brouwer
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2010 Sep-Oct Vol. 28 Issue 5 Pg. 661-8 ISSN: 0392-856X [Print] Italy
• PMID: 20822711 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents
• Autoantibodies
• Immunoglobulin G
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Infliximab
• Adalimumab
• Etanercept

Topics

• Adalimumab
• Adult
• Antibodies, Monoclonal (immunology, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antirheumatic Agents (immunology, therapeutic use)
• Autoantibodies (immunology)
• Etanercept
• Female
• Health Status
• Humans
• Immunoglobulin G (immunology, therapeutic use)
• Infliximab
• Longitudinal Studies
• Male
• Middle Aged
• Receptors, Tumor Necrosis Factor (immunology, therapeutic use)
• Severity of Illness Index
• Spondylitis, Ankylosing (drug therapy, immunology, physiopathology)
• Tumor Necrosis Factor-alpha (immunology)