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Methotrexate reduces immunogenicity in adalimumab treated rheumatoid arthritis patients in a dose dependent manner
  1. Charlotte L Krieckaert1,
  2. Michael T Nurmohamed1,2,
  3. Gerrit Jan Wolbink1,3
  1. 1Department of Rheumatology, Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands
  2. 2Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Immunopathology, Sanquin Research and Landsteiner Laboratory Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Charlotte L Krieckaert, Jan van Breemen Research Institute | Reade, Reumatology, dr Jan van Breemenstraat 2, Amsterdam 1056 AB, The Netherlands; c.krieckaert{at}

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Immunogenicity of adalimumab could impair important treatment outcome parameters in patients with rheumatoid arthritis (RA). Patients who developed antiadalimumab antibodies (AAA) during a 3 year time period achieved less often minimal disease activity or remission and treatment failure occurred more often compared with patients without AAA.1 There were remarkable baseline differences: patients developing AAA had more long-standing, severe disease and less often used concomitant medication including lower doses of methotrexate (MTX), compared with patients not developing AAA. In literature, a favourable effect of concomitant MTX use on the immunogenicity of adalimumab for several inflammatory conditions is suggested.2

To investigate which MTX dose is sufficient to reduce immunogenicity, patients of …

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