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. 2024 Oct 14;11(3):364-370.
doi: 10.5152/eurjrheum.2024.24013.

Factors Associated with the Development of Anti-drug Antibodies to TNFi and the Consequences for Axial Spondyloarthritis: A Two-year Follow-up Study

Elif Durak Ediboğlu  1 , Muhammed Çınar  2 , Didem Kozacı  3 , Dilek Solmaz  1 , Gökhan Sargın  4 , Ömer Karadağ  5 , Gülay Kınıklı  6 , Umut Kalyoncu  5 , Sedat Yılmaz  2 , Taşkın Şentürk  4 , Gökhan Kabadayı  1 , Gökhan Keser  7 , Gülen Hatemi  8 , Kübra Kaya  3 , Mustafa Özmen  1 , Figen Yargucu  7 , Yeşim Özgüler  8 , Ayşe Cefle  9 , Önay Gerçik  10 , Bünyamin Kısacık  11 , Servet Akar  1
Affiliations

Factors Associated with the Development of Anti-drug Antibodies to TNFi and the Consequences for Axial Spondyloarthritis: A Two-year Follow-up Study

Elif Durak Ediboğlu et al. Eur J Rheumatol. .

Abstract

Objective: To evaluate the development of anti-drug antibodies (ADAb) against tumor necrosis factor inhibitors (TNFi) therapy during a 2-year period and search the factors linked to patients with axial spondyloarthritis (axSpA).

Methods: Biologic-naive patients with axSpA were included in this observational study. Serum drug levels and ADAb were measured at weeks 12, 24, 52, and 104 of treatment by enzyme-linked immunosorbent assay (ELISA). The development of ADAb and factors related to ADAb over time were investigated using generalized estimating equations (GEE).

Results: A total of 180 patients with axSpA (116 male, mean (±SD) 45.6 (±11.9) years) who started TNFi treatment (etanercept (32.2%), adalimumab (27.2%), golimumab (20.6%), infliximab (20%)) were included. In the etanercept treatment group, only 1 patient had ADAb at 12 weeks and 24 weeks. Anti-drug antibodies against TNFi drugs were present in the adalimumab group in 32.7% of patients and in the infliximab group in 21.2% of patients at 12 weeks, and the proportion of ADAb-positive patients were found to be stable throughout the follow-up for adalimumab- and infliximab-treated patients. In the golimumab group, one patient had ADAb against golimumab at 12 weeks and the proportion of ADAb-positive patients increased throughout follow-up. In longitudinal analysis, baseline age, TNFi type, longitudinal Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and ASDAS-CRP scores, serum C-eeactive protein (CRP) levels, presence of adverse events and treatment discontinuation were associated with the presence of ADAb.

Conclusion: The development of ADAb against TNFi therapy is associated with younger age, high disease activity, the development of adverse events and more common treatment discontinuation in patients with axSpA during 2-year follow-up.

Keywords: Axial spondyloarthritis; anti-drug antibody; tumor necrosis factor inhibitors.

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Conflict of interest statement

Declaration of Interests: The authors have no conflict of interest to declare.

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