Background/Purpose:

TNFα blockers have been shown to produce immunogenecity in patients with rheumatoid arthritis, spondyloarthrritis and inflammatory bowel diseases. Data on the induction of anti-drug antibodies against TNF alpha blockers in psoriatic arthritis is scarce. The purpose of this study was to assess the prevalence of anti-drug antibodies (ADA) against infliximab , adalimumab and etanercept in a cohort of patients with psoriatic arthritis (PsA).

Methods:

Patients with PsA treated for at least 3 months with adalimumab (n=48), infliximab (n=24) and etanercept ( n=21) participated in this study. Clinical activity was assessed using the DAS 28, physician and patient global assessment using a VAS of 100 mm, psoriasis assessement of severity score (PASI) , BASDAI, ESR and CRP.

Results:

ADA were  detected in 26 (55%) patients on adalimumab,  5 (28%)  on infliximab and none of the patients on etanercept. A significant correlation was found between the presence of ADA and drug levels of adalimumab and infliximab. A significant correlation was found between drug levels of adalimumab and global physician and patient assessment, and the PASI. In patients treated with infliximab, ADA was associated with higher DAS and PASI, Twenty-six % of the patients were concomitantly treated with methotrexate (MTX). A significant correlation  between the use of MTX and the absence of ADA was demonstrated in patients treated with infliximab and adalimumab.

Conclusion:

A substantial proportion of patients with PsA develop anti drug antibodies to adalimumab and infliximab. The use of MTX seems to lower immunogenecity. The presence of ADA correlated with drug levels and several parameters of disease activity.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/immunogenicity-of-tnf%ce%b1-blockers-in-patients-with-psoriatic-arthritis/