Plasma trough levels of adalimumab and infliximab in terms of clinical efficacy during the treatment of psoriasis

Abstract

We examined the relation between adalimumab and infliximab plasma trough levels, anti-adalimumab and anti-infliximab antibody formation. We analyzed plasma from 32 adalimumab-treated and 20 infliximab-treated psoriasis patients for evaluating trough levels of each drug. The presence of anti-adalimumab and anti-infliximab antibodies was analyzed and the severity of psoriasis was evaluated. At week 28, 25 out of 32 and at week 48, 21 out of 30 adalimumab-treated patients maintained as more than PASI 75. At week 28, 12 out of 20 and at week 48, nine out of 18 infliximab-treated patients were evaluated as more than PASI 75. In patients treated with 40 mg adalimumab every other week, the mean trough level was 7.62 lg/mL (range, 0.05-10.6) at week 48. In patients treated with 80 mg adalimumab every other week, the mean trough level was 8.61 lg/mL (range, 0.08-13.5) at week 48. Mean trough level of infliximab-treated cases (4.1-5.2 mg/kg; mean, 4.6) was 4.64 lg/mL (range, 0.03-16.9) at week 48. Anti-adalimumab antibody was detected in five out of 32 cases and anti-infliximab antibody was detected in six out of 20 cases, respectively, at weeks 24 and 48. The optimal cut-off values of adalimumab and infliximab concentration for more than PASI 75 were more than 7.84 lg/mL and more than 0.92 lg/mL, respectively. The trough levels of adalimumab and infliximab in psoriasis patients were positively associated with clinical response and were significantly lower in cases having anti-adalimumab or anti-infliximab antibodies.

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

“…The average trough level in our patients was 1.90 ug/ml (range 0.40-3.88 ug/ml) and 1.38 (range 0.61-4.04) respectively. It is higher than Takahashi et al [3] published recently in their study of 20 patients treated with infliximab. He found that the minimum trough level of infliximab in good responders was 0.92 ug/ml.…”

Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

“…) and also higher than those reported in other immune-mediated inflammatory diseases [35][36][37]. Consequently, it will be of interest to study whether a lower dose would achieve the same results in patients with active disease.…”

Challenges of biological therapy in patients with pustular psoriasis coexisting with psoriatic arthritis

“…The discrepancy in study results may suggest that there are other, as yet unexplored, factors with an impact on the efficacy of treatment. Predictors of response autorów uważa, że przyczyna skróconego czasu działania leku może mieć podłoże immunologiczne, takie jak powstawanie przeciwciał przeciwko lekowi [3,21,[30][31][32][33][34][35]. Mogą one hamować jego działanie w terapii długotrwałej lub zmniejszać skuteczność kolejnej zastosowanej terapii biologicznej.…”

“…Wiedza ta umożliwiłaby to biologic therapy have been mentioned to include patient gender [21,24,25,29] and body weight [26]. Many authors claim that a reduced duration of drug action may be attributed to immune factors such as the development of antibodies against the drug [3,21,[30][31][32][33][34][35]. They may inhibit drug action during longterm treatment or reduce the efficacy of the subsequent therapy with biologics.…”