Regresar

Clinical usefulness in measuring infliximab and human anti-chimeric antibodies

Abstract:

Introduction: infliximab (IFX), a chimeric antibody against tumour necrosis factor-alpha, is usedin the treatment of patients with several inflammatory diseases, but it can lead to the formationof human anti-chimeric antibodies (HACA). HACA and low IFX serum levels have been associatedwith lack or loss of response, and infusion reactions. The usefulness of measuring the IFX andHACA concentrations is evaluated.Material and methods:IFX and HACA were measured using a relatively new ELISA technique ina cohort of 110 patients treated with IFX. Serum samples were collected immediately beforepatients were given the next drug infusion. The patients had received a median dose of 5 mg/kg,with dose intervals adjusted to the patient's disease activity, usually every 8 weeks. The mediannumber of infusions was 17.Results: HACA were identified in 10 patients, and therapeutic IFX concentrations were observedin 37 patients. Eight out of 10 positive HACA patients had gastrointestinal disorders, and thetherapy was discontinued in 9 of them. The concomitant use of immunosuppressants did notreduce the risk of HACA formation. Among 100 patients with no HACA, 79 continued on thesame dose, 16 required a dose adjustment, 2 discontinued treatment, and 3 were switched toanother biological agent.Conclusions: Blood IFX and HACA concentrations should be monitored in patients receiving IFX,as it may be useful to optimize dose regimens or avoid use of inadequate therapy. © 2014 AEBM, AEFA y SEQC. Published by Elsevier España, S.L. All rights reserved.C.