Extent and clinical consequences of antibody formation against adalimumab in patients with plaque psoriasis.
OBJECTIVE
To investigate the extent antibodies to adalimumab are formed in patients with plaque psoriasis and whether these antibodies have clinical consequences. Also, to examine the relationship between antibodies to adalimumab and adalimumab trough titers.


METHODS
Prospective observational cohort study.


METHODS
Two Dutch dermatology departments in university hospitals.


METHODS
All consecutive patients starting a regimen of adalimumab for chronic plaque psoriasis. Patients were screened and fulfilled the Dutch reimbursement criteria for adalimumab to treat psoriasis.


METHODS
Adalimumab treatment (per label).


METHODS
The titer of antibodies to adalimumab, the adalimumab trough concentration, and the Psoriasis Area and Severity Index at weeks 12 and 24.


RESULTS
Antibodies to adalimumab were detected in 13 of 29 patients (45%) during 24 weeks of treatment. Differences in response rates among patients with low, high, and no titers of antibodies to adalimumab were significant at weeks 12 and 24 (P = .04 and P < .001, respectively). The median adalimumab trough concentrations varied significantly among patients with low, high, and no titers of antibodies to adalimumab (1.30 [range, 0.01-5.50], 0.0 [range, 0.0-0.0], and 9.6 [range, 0.0-22.6] mg/L, respectively; P < .001). At week 24, the median adalimumab trough concentrations also differed significantly among good responders, moderate responders, and nonresponders (9.7 [range, 0.0-22.6], 8.9 [range, 3.2-12.6], and 0.0 [range, 0.0-13.3] mg/L, respectively; P = .01).


CONCLUSIONS
Antibodies to adalimumab are associated with lower serum adalimumab trough concentrations and with nonresponse or loss of response to adalimumab in patients with plaque psoriasis.
Department of Dermatology, Academic Medical Center, University of Amsterdam, Room A0-252, PO Box 22700, 1100 DE Amsterdam, the Netherlands. l.l.lecluse@amc.uva.nl
Lidian L A
LL
Lecluse
Rieke J B
RJ
Driessen
Phyllis I
PI
Spuls
Elke M G J
EM
de Jong
Steven O
SO
Stapel
Martijn B A
MB
van Doorn
Jan D
JD
Bos
Gert-Jan
GJ
Wolbink
D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000097:blood* / Q000276:immunology* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000097:blood / Q000276:immunology* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000917:Antibody Formation; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D000068879:Adalimumab