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Decreased clinical response to infliximab in Ankylosing Spondylitis (AS) is correlated with anti-infliximab formation.
  1. Mirjam K. de Vries (mk.devries{at}vumc.nl)
  1. VU University Medical Center, Netherlands
    1. Gerrit Jan Wolbink (g.wolbink{at}sanquin.nl)
    1. Sanquin Research, Netherlands
      1. Steven Stapel (s.stapel{at}sanquin.nl)
      1. Sanquin Research, Netherlands
        1. Henk de Vrieze (h.devrieze{at}sanquin.nl)
        1. Sanquin Research, Netherlands
          1. J Christiaan Van Denderen (c.v.denderen{at}janvanbreemen.nl)
          1. Jan van Breemen Instituut, Netherlands
            1. Ben A.C. Dijkmans (secr.reumatologie{at}vumc.nl)
            1. VU University Medical Center, Netherlands
              1. Lucien Aarden (l.aarden{at}sanquin.nl)
              1. Sanquin Research, Netherlands
                1. Irene E van der Horst-Bruinsma (ie.vanderhorst{at}vumc.nl)
                1. VU University Medical Center, Netherlands

                  Abstract

                  Objectives: Correlation of serum trough infliximab levels and antibodies to infliximab (anti-infliximab) with clinical response in Ankylosing Spondylitis (AS).

                  Methods: According to the international assessments in Ankylosing Spondylitis (ASAS) consensus statement patients were treated with infliximab (5 mg/kg) every 6 weeks after a starting regimen. Preinfusion sera were collected at baseline, 24 and 54 weeks. During every visit ASAS 20% response was assessed, additionally laboratory tests were performed.

                  Results: After 24 weeks of treatment 24 patients out of 38 (63%) fulfilled ASAS 20% response criteria and 21 (53%) after 54 weeks. After 54 weeks 11 (29%) patients showed undetectable serum trough infliximab levels and detectable anti-infliximab; six of these patients developed an infusion reaction. Anti-infliximab was significantly more often found in ASAS 20% non-responders compared to responders at week 54 (p=0.036). The serum trough infliximab levels of patients with anti-infliximab were significantly lower (mean: 0.02 mg/l) than in patients without anti-infliximab (mean: 12.7 mg/l) (p<0.0001).

                  Conclusions: In AS, high levels of serum trough infliximab correlated with a good clinical response. Detection of anti-infliximab within 54 weeks is associated with undetectable serum trough infliximab levels, a reduced response to treatment and an increased risk of developing an infusion reaction.

                  • antibodies to infliximab
                  • infliximab
                  • spondylitis, ankylosing
                  • tumor necrosis factor-alpha

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