title: Extent and consequences of antibody formation against adalimumab in patients with psoriasis: one-year follow-up.
abstract: OBJECTIVE
  In a previously reported cohort of 29 patients with plaque-type psoriasis followed up for 24 weeks, clinically relevant antidrug antibody (ADA) to adalimumab was frequently found. Long-term data were lacking. We now present the extension of this study: 80 patients followed up for 1 year.
  
  
  OBJECTIVE
  To assess the extent of ADA and its clinical consequences after 24 weeks of adalimumab treatment for psoriasis in a cohort of 80 patients.
  
  
  METHODS
  A multicenter cohort study, performed in the outpatient dermatology clinic of 2 academic hospitals, included 80 sequential patients receiving adalimumab therapy for plaque-type psoriasis and had a follow-up of 1 year. Outcome assessors were not aware of the presence of antibodies to adalimumab or the adalimumab serum concentration when assessing patients' Psoriasis Area and Severity Index (PASI), and personnel analyzing serum samples were blinded to patients' PASI.
  
  
  METHODS
  For 80 patients treated with adalimumab for psoriasis, disease severity (PASI) was assessed, blood samples were collected, and adalimumab and ADA concentrations was determined at baseline and at weeks 12, 24, and 52.
  
  
  METHODS
  Patient PASI and adalimumab and ADA concentrations.
  
  
  RESULTS
  Antidrug antibody formed in 49% of patients, before week 24 in 90% of them. Adalimumab and ADA concentrations, clinical response and ADA concentration, and adalimumab concentration and clinical response had correlations of -0.872, -0.606, and 0.519, respectively. The adalimumab dose interval was shortened because of lack of efficacy in 15 patients, 7 with and 8 without ADA; improvement in responder status occurred in 1 of 7 and 4 of 8, respectively.
  
  
  CONCLUSIONS
  Patients with no ADA formation in the first 24 weeks of treatment have little chance of it in the following 24 weeks. The presence of ADA is strongly correlated with adalimumab concentration and greatly influences clinical response. If ADA is present, dose interval shortening is less useful.
authors.affiliation: Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Stef P
authors.initials: SP
authors.lastname: Menting
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Paula P M
authors.initials: PP
authors.lastname: van Lümig
authors.affiliation: Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Anna-Christa Q
authors.initials: AC
authors.lastname: de Vries
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Juul M P A
authors.initials: JM
authors.lastname: van den Reek
authors.affiliation: Laboratory for Monoclonal Therapeutics, Sanquin Diagnostic Services, Amsterdam, the Netherlands.
authors.forename: Desiree
authors.initials: D
authors.lastname: van der Kleij
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Elke M G J
authors.initials: EM
authors.lastname: de Jong
authors.affiliation: Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Phyllis I
authors.initials: PI
authors.lastname: Spuls
authors.affiliation: Department of Dermatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Lidian L A
authors.initials: LL
authors.lastname: Lecluse
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000276:immunology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000276:immunology / Q000627:therapeutic use*; D000917:Antibody Formation / Q000276:immunology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000068879:Adalimumab