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Adalimumab Antibodies Linked to Treatment Failure

Last Updated: April 13, 2011.

Development of antibodies against adalimumab may have an effect on treatment discontinuation, disease activity, and remission in patients with rheumatoid arthritis, according to a study published April 13 in an infectious disease and immunology themed issue of the Journal of the American Medical Association.

WEDNESDAY, April 13 (HealthDay News) -- Development of antibodies against adalimumab may have an effect on treatment discontinuation, disease activity, and remission in patients with rheumatoid arthritis (RA), according to a study published April 13 in an infectious disease and immunology themed issue of the Journal of the American Medical Association.

Geertje M. Bartelds, M.D., from the Jan van Breemen Research Institute in Amsterdam, Netherlands, and colleagues evaluated the course of antidrug antibody development against fully human monoclonal antibody adalimumab and its clinical relevance in 272 patients with RA. Patients were treated with adalimumab, and trough serum samples were obtained at baseline and at eight points up to 156 weeks during the three-year follow-up. Outcomes (treatment discontinuation, minimal disease activity, and clinical remission) were compared in patients with and without antidrug antibodies.

The investigators found that 28 percent of patients developed antiadalimumab antibodies, 67 percent of these during the first 28 weeks of treatment. Adalimumab concentrations were higher in patients without antiadalimumab antibodies. Patients with antiadalimumab antibodies were more likely to discontinue participation because of treatment failure compared to those without antibodies (38 versus 14 percent; hazard ratio [HR], 3.0). Patients without antiadalimumab antibodies more often had minimal disease activity (48 versus 13 percent) and achieved sustained remission more often than patients with antiadalimumab antibodies (34 versus 4 percent). Patients with antibodies were less likely to have sustained minimal disease activity (HR, 3.6) and achieve remission (HR, 7.1).

"This study demonstrated associations between antidrug antibodies and important long-term clinical end points -- discontinuation of treatment, minimal disease activity, and remission," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, including Abbot Laboratories and Wyeth Pharmaceuticals, both of which funded the study.

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