title: The effect of antidrug antibodies on the sustainable efficacy of biologic therapies in rheumatoid arthritis: practical consequences.
abstract: Biologic therapies, predominantly TNF-α inhibitors, have revolutionized the treatment of rheumatoid arthritis (RA). However, their clinical utility can be limited by the development of antidrug antibodies (ADAs). Immunogenicity is a complex phenomenon related to various drug, disease, and patient characteristics, and may be more common with the monoclonal antibodies than with etanercept, a soluble TNF receptor-Fc immunoglobulin fusion protein. Neutralizing antibodies - those that hinder bioactivity by preventing drug molecules from binding to TNF - are correlated with reduced serum drug concentrations, loss of therapeutic response, adverse events, and treatment discontinuation. Cost-effective use of these agents will depend on further research into drug and ADA assays, and how they should guide dose reduction or switching strategies.
authors: Rheumatology Section, Pontifical Catholic University RS, School of Medicine, Porto Alegre, Brazil.
authors: Mauro
authors: M
authors: Keiserman
authors: Catalin
authors: C
authors: Codreanu
authors: Rohini
authors: R
authors: Handa
authors: Daniel
authors: D
authors: Xibillé-Friedmann
authors: Eduardo
authors: E
authors: Mysler
authors: Francisco
authors: F
authors: Briceño
authors: Servet
authors: S
authors: Akar
mesh_terms: D000818:Animals; D019138:Antibodies, Blocking / Q000378:metabolism*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000191:economics / Q000276:immunology / Q000628:therapy*; D057915:Drug Substitution; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007167:Immunotherapy; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D028761:Withholding Treatment
chemical_list: D019138:Antibodies, Blocking; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D000068800:Etanercept
keywords: TNF antagonists; abatacept; adalimumab; antidrug antibodies; biologic therapies; etanercept; immunogenicity; infliximab; rheumatoid arthritis; rituximab