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High levels of human anti-human antibodies to adalimumab in a patient not responding to adalimumab treatment
  1. G M Bartelds1,
  2. G J Wolbink1,
  3. S Stapel2,
  4. L Aarden2,
  5. W F Lems3,
  6. B A C Dijkmans3,
  7. M T Nurmohamed3
  1. 1Jan van Breemen Institute, Amsterdam, The Netherlands
  2. 2Sanquin Research, Amsterdam
  3. 3VU University Medical Centre, Amsterdam
  1. Correspondence to:
    M T Nurmohamed
    Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands;m.nurmohamed{at}

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Adalimumab is an effective treatment for rheumatoid arthritis. However, a substantial proportion of patients with rheumatoid arthritis either do not respond or lose their initial response.1 We report a patient who initially responded to adalimumab treatment, but in whom disease activity increased as treatment continued. We believe that this lack of response to adalimumab is probably caused by the formation of human anti-human antibodies (HAHAs).

A 69-year-old woman with rheumatoid arthritis (diagnosed in 1991) and progressive joint destruction had active disease despite treatment with methotrexate 10 mg weekly and prednisone 7.5 mg/day. Therefore, treatment with adalimumab, 40 mg every other week, was started, in combination …

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  • Competing interests: None.

  • Informed consent was obtained for publication of the patient’s details described in this report.

    Ethical approval: Ethics committee approval was secured for the study reported by the Stichting Slotervaartziekenhuis, Medisch Ethische Toetsingscommissie, Amsterdam.