Letter: should direct‐acting antiviral drugs be used concomitantly with chemotherapeutic drugs in hepatitis C virus‐infected patients with cancer?

Abstract

Linked ContentThis article is linked to Economides et al papers. To view these articles visit https://doi.org/10.1111/apt.13825 and https://doi.org/10.1111/apt.13937.

Letter: can addition of an immunomodulator really reverse antibody formation and loss of response in patients treated with adalimumab?

“…1 They have reported a similar statement for infliximab. 2 Unfortunately, the prospect of reducing circulating levels of anti-drug antibodies (ADA) is pharmaceutically and clinically challenging, especially when aiming at selective prevention of ADA production (immunological tolerance).…”

“…3 Even so-called drug-tolerant ADA assays may be affected if samples contain high levels of drug as in the Ungar study. 1,5 If ADA do indeed disappear from the circulation, this by itself does not permit conclusions regarding ADA formation (and drug immunogenicity), as the data may result from augmented elimination of ADA, rather than diminished ADA production from B-lymphocytes/plasma cells. 3,8 In the Ungar study, 52% of patients had their ª 2017 John Wiley & Sons Ltd Such an effect is likely to reduce TNF-alpha production in previously inflamed tissues.…”

Letter: should direct‐acting antiviral drugs be used concomitantly with chemotherapeutic drugs in hepatitis C virus‐infected patients with cancer? Authors’ reply

“…In their reply letter, Jiang et al, 1 reported that we included a heterogeneous group of cancer patients receiving concomitant treatment for various reasons. Whereas eight of our patients experienced adverse events (AEs) that were serious (grade 3 or grade 4), only two of the patients experienced grade 4 AEs.…”

“…3 Even so-called drug-tolerant ADA assays may be affected if samples contain high levels of drug as in the Ungar study. 1,5 If ADA do indeed disappear from the circulation, this by itself does not permit conclusions regarding ADA formation (and drug immunogenicity), as the data may result from augmented elimination of ADA, rather than diminished ADA production from B-lymphocytes/plasma cells. 3,8 In the Ungar study, 52% of patients had their…”