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THU0364 Immunogenicity of anti-tnf drugs and clinical response in patients with spondyloarthritis
- Source :
- Poster Presentations.
- Publication Year :
- 2017
- Publisher :
- BMJ Publishing Group Ltd and European League Against Rheumatism, 2017.
-
Abstract
- Background Antidrug antibodies (ADAb) seem to be associated with a loss of response in immune-mediated inflammatory diseases (1) and in psoriatic arthritis (2). Objectives To assess the effect of ADAb on clinical response in patients with spondyloarthritis (SpA) treated with anti-TNF drugs. Methods We conducted a systematic literature review of controlled trials and observational studies assessing the effect of ADAb on response to anti-TNF drugs (Adalimumab (ADL), Certolizumab (CTZ), Etanercept (ETA), Golimumab (GOL) and Infliximab (INF)) in patients with axial or peripheral SpA. Databases analysed were PubMed, the Cochrane library, and ACR/EULAR meeting abstracts, until January 2017. A meta-analysis was performed using the inverse variance approach and statistical heterogeneity was assessed with the Cochran Q-test and I 2 values. A statistical threshold of 5% was considered as significant. Results Over 1,387 publications screened, 7 studies were selected for meta-analysis (3–9). These studies were observational studies (n=6) or controlled trial (n=1); involved patients with axial or peripheral SpA (n=6) or psoriatic arthritis (n=1); included treatments with ADL (n=4), ETA (n=1), INF and INF biosimilar (n=2), or various anti-TNF drugs (n=1). ADAb rates varied between anti-TNF drugs: 0% for ETA, 13.6–31.4% for ADL, 0–28.9% for INF. Patients with ADAb were less often responders than patients without ADAb in 6 studies, more often responders in one study, while the risk ratio (RR) for response was not assessable in one study due to the absence of ADAb. The weighted pooled RR (95% CI) for response to anti-TNF drugs was 0.73 (0.54–0.98) in ADAb+ in comparison with ADAb- patients (p=0.04) (see figure). There were trends towards more infusion reactions and lower serum drug levels in patients with ADAb (data not shown). Conclusions According to the results of this meta-analysis, ADAb positivity is associated with a lower rate of response to anti-TNF agents in patients with SpA. References The immunogenicity of anti-TNF therapy in immune-mediated inflammatory diseases: a systematic review of the literature with a meta-analysis, Garces.S and al, ARD 2014; 72:1947–1955. The comparative immunogenicity of biologic therapy and it9s clinical releavance in psoriatic arthritis: a systematic review of the literature, Balsa.A and al, ACR 2016, Abstract number 1691. Disclosure of Interest None declared
- Subjects :
- 030203 arthritis & rheumatology
0301 basic medicine
medicine.medical_specialty
business.industry
Cochrane Library
medicine.disease
Golimumab
Infliximab
Surgery
law.invention
Etanercept
03 medical and health sciences
Psoriatic arthritis
030104 developmental biology
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Relative risk
medicine
Adalimumab
business
medicine.drug
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Poster Presentations
- Accession number :
- edsair.doi...........ae882ad3e2199116d283973b2d4729ee