Anti‐infliximab antibody status and its relation to clinical response in psoriatic patients: A pilot study

Abstract

Although the mechanisms underlying the loss of response to infliximab are not completely understood, the formation of antibodies to infliximab (ATI) are thought to play a role. The aim of this study was to investigate the presence of ATI in psoriatic patients and to evaluate its relationship to the clinical response. Fifteen patients with psoriasis were treated with infliximab (5 mg/kg) every 8 weeks after an initial three-dose induction treatment. An enzyme linked immunosorbent assay kit was used for analyzing the presence of ATI in sera. Effectiveness assessments included the change in Psoriasis Area and Severity Index (PASI) compared with study entry. Five (33.3%) patients developed ATI. While 5.9 +/- 3.2 infliximab infusions achieved a fall in the PASI score from a mean of 20.4 +/- 8.3 to 5.3 +/- 2.4 in ATI-negative patients, these values changed from 23.3 +/- 11 to 10 +/- 4.9 after 9 +/- 5.2 infusions in ATI-positive patients. Our results suggested that ATI measured in psoriatic patients are of clinical importance. Therefore, monitoring for the induction of ATI and rescue strategies should be developed to avoid or to maintain a delay in ATI development.

Antidrug antibodies in psoriasis: a systematic review

“…Four were RCTs, four were prospective cohort studies and two were retrospective studies. 13,26,[29][30][31][32][33][34][35][36] AIAs were reported in 5Á4-43Á6% of patients (Table 1). Four studies used enzyme-linked immunosorbent assays (ELISAs) to detect AIAs, and six studies tested for AIAs at drug trough levels.…”

“…Four studies used enzyme-linked immunosorbent assays (ELISAs) to detect AIAs, and six studies tested for AIAs at drug trough levels. 26,29,31,32,34,36 Three studies reported an association between AIAs and lower serum infliximab concentrations. 31,34,36 Five studies noted an association between AIAs and decreased clinical improvement.…”

Correlation between elevation of serum antinuclear antibody titer and decreased therapeutic efficacy in the treatment of Behçet’s disease with infliximab

“…It has also been found that repeated infusion of IFX leads to induction of antibodies to IFX (ATI) that reduce the efficacy of IFX. This phenomenon has been a serious issue in rheumatoid arthritis [47], Crohn's disease [48], psoriasis [49,50] and BD [51] therapy.…”

Management of Infliximab Treated Patients with Psoriasis Based On Infliximab Plasma Levels and Antibodies to Infliximab

“…Several papers, mainly in rheumatology, mention the positive effect of methotrexate (in gastroenterology also of azathioprine) to reduce the production of antibodies [2,[10][11][12][13][14][15][16]. Nevertheless, the beneficial effect of MTX on the formation of ATI in psoriatic patients is described only rarely [2,13]. At our department, we start with a dose of 7.5 mg/week and every week we increase the dose by 2.5 mg up to the final dose of 12.5-15.0 mg/week.…”