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Influence of anti-infliximab antibodies and residual infliximab concentrations on the occurrence of acquired drug resistance to infliximab in rheumatoid arthritis patients.

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Influence of anti-infliximab antibodies and residual infliximab concentrations on the occurrence of acquired drug resistance to infliximab in rheumatoid arthritis patients.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Finckh, Axel Dudler, Jean Wermelinger, Felix Ciurea, Adrian Kyburz, Diego Gabay, Cem Bas, Sylvette
Organization	physicians of SCQM
Description	Country affiliation: Switzerland Author Affiliation: Finckh A ( Division of Rheumatology, Department of Internal Medicine, University Hospital of Geneva, 26, avenue Beau-Sejour, 1211 Geneva, Switzerland. axel.finckh@hcuge.ch)
Abstract	BACKGROUND: Infliximab (IFX) can be immunogenic for humans and lead to the formation of antibodies against IFX (anti-IFX Ab), which could induce acquired IFX resistance. OBJECTIVE: To test whether the presence of anti-IFX Ab and residual circulating IFX levels are associated with acquired IFX resistance in RA. METHODS: A multivariate logistic regression was used to analyze the relationship between anti-IFX Ab, residual IFX concentrations, and acquired IFX resistance in a nested cohort within the Swiss RA registry (SCQM-RA). RESULTS: Sixty-four RA patients on longstanding IFX therapy were included; 24 with an acquired therapeutic resistance to IFX and 40 with continuous good response to IFX. The two groups had similar disease characteristics, but patients with acquired IFX resistance required significantly higher dosage of IFX (5.4 mg/kg versus 4.3 mg/kg, p=0.02) and shorter infusion intervals (7.1 versus 8.7 weeks, p=0.01) than long-term good responders. The presence of residual IFX tended to be associated with a decreased risk of acquired therapeutic resistance (OR 0.4 [95% CI: 0.1-1.5]), while the presence of anti-IFX Ab tended to be associated with an increased risk of acquired therapeutic resistance (OR: 1.8 [95% CI: 0.4 - 9.0]). The presence of either high anti-IFX Ab levels or low residual IFX concentrations was strongly associated with acquired therapeutic resistance to IFX (OR 5.9, 95% CI 1.3 - 26.6). However, just 42% of patients with acquired IFX resistance had either low IFX or high anti-IFX Ab levels. CONCLUSION: These results suggest that the assessment of anti-IFX Ab and residual IFX levels is of limited value for individual patients in routine clinical care.
File Format	HTM / HTML
ISSN	1297319X
Issue Number	4
Volume Number	77
e-ISSN	17787254
Journal	Joint Bone Spine
Language	English
Publisher	Elsevier
Publisher Date	2010-07-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Rheumatology Antibodies, Anti-idiotypic Blood Antibodies, Monoclonal Therapeutic Use Arthritis, Rheumatoid Drug Therapy Drug Resistance Aged Aged, 80 And Over Biological Markers Case-control Studies Cohort Studies Dose-response Relationship, Drug Female Humans Infliximab Logistic Models Male Middle Aged Time Factors Treatment Outcome Journal Article Multicenter Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Rheumatology

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