Drug trough levels predict therapeutic responses to dose reduction of adalimumab for rheumatoid arthritis patients during 24 weeks of follow-up

Rheumatology
Der-Yuan ChenJoung-Liang Lan

Abstract

To evaluate the impact of adalimumab (ADA) dose-halving on therapeutic responses and drug levels, the differences in drug levels among patients with different therapeutic responses and the optimal baseline cut-off ADA levels for predicting persistent remission or low disease activity (LDA) at week 24 of dose-halving therapy in 64 RA patients who had already achieved LDA or remission at baseline. Anti-ADA antibody levels were determined by bridging ELISA, ADA levels were evaluated using sandwich ELISA and therapeutic responses were assessed by the 28-joint DAS change. The optimal cut-off drug levels for predicting persistent remission were determined by receiver operating characteristic curve analysis. At baseline, 25 (39.1%) and 39 (60.9%) patients had achieved remission and LDA, respectively. After 24 week ADA dose-halving, persistent remission was observed in 23 patients, remission turned LDA in 2 patients, persistent LDA in 24 patients and disease flare in 15 (23.5%) patients. Three patients who developed anti-ADA antibodies at week 24 of dose-halving had very low drug levels and disease flare. Among 61 anti-ADA antibody-negative patients, ADA levels declined by half after 24 weeks of dose-halving (median 5.5 vs 2.6 μg/ml). ...Continue Reading

References

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Citations

Mar 4, 2017·Rheumatology and Therapy·Lise M VerhoefAlfons A den Broeder
Jun 2, 2017·Therapeutic Drug Monitoring·Ji S van BezooijenTeun van Gelder
Feb 2, 2018·Current Opinion in Rheumatology·Alfons A den BroederBart J F van den Bemt
Nov 22, 2017·Nature Reviews. Rheumatology·Joachim R Kalden, Hendrik Schulze-Koops
Feb 21, 2018·Journal of Clinical Pharmacology·Hannah HoseyniHonghui Zhou
May 8, 2018·Arthritis & Rheumatology·Cristina RedondoAlejandro Balsa
Jan 8, 2018·Annals of the Rheumatic Diseases·Denis Mulleman, Alejandro Balsa
Nov 18, 2018·Expert Opinion on Drug Safety·Laurence DuquennePaul Emery
Feb 26, 2020·Therapeutic Advances in Musculoskeletal Disease·Martin PerryAndrew McGucken
Jun 11, 2019·Expert Review of Clinical Immunology·Konstantinos PapamichaelAdam S Cheifetz
Jul 28, 2020·Rheumatology International·Letícia B VasconcelosTais F Galvao
Dec 19, 2016·British Journal of Clinical Pharmacology·Carla BastidaDolors Soy
Jan 10, 2019·Arthritis Research & Therapy·Jordi GratacósUNKNOWN REDES-TNF investigators
Mar 23, 2019·Rheumatology International·José Miguel Senabre GallegoUNKNOWN AIRE-MB Group

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