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Response to: Comment on l’Ami et al titled ‘Successful reduction of overexposure in patients with rheumatoid arthritis with high serum adalimumab concentrations: an open-label, non-inferiority, randomised clinical trial’ by den Broeder et al
  1. Merel J l’Ami1,
  2. Charlotte L M Krieckaert1,2,
  3. Michael T Nurmohamed2,
  4. Ronald F van Vollenhoven3,
  5. Theo Rispens4,
  6. Maarten Boers5,
  7. Gerrit Jan Wolbink1
  1. 1Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
  2. 2Department of Reumatology, Amsterdam Rheumatology and immunology Center, Location VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Location Amsterdam Medical Center, Amsterdam, The Netherlands
  4. 4Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
  5. 5Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
  1. Correspondence to Merel J l’Ami, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam 1056 AB, The Netherlands ; m.lami{at}reade.nl

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We thank den Broeder et al for their interest in our study and for their suggestions concerning further research.1 Our study did not target the broad issue of dose tapering, but focused on the population of patients with rheumatoid arthritis with high adalimumab concentrations (>8 µg/mL).2 We hypothesised that given the wide variation in serum concentrations on standard dosing and the established plateau in the concentration–response relationship—even in active disease3—there would be a role for individualised dosing to optimise adalimumab therapy. Unlike den Broeder et al, we find nothing peculiar about our research question or design …

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