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Anti-adalimumab antibodies and adalimumab concentrations in psoriatic arthritis; an association with disease activity at 28 and 52 weeks of follow-up
  1. Erik H Vogelzang1,
  2. Eva L Kneepkens1,
  3. Michael T Nurmohamed1,
  4. Arno W R van Kuijk1,
  5. Theo Rispens2,
  6. Gertjan Wolbink1,2,
  7. Charlotte L M Krieckaert1
  1. 1Department of Rheumatology, Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands
  2. 2Department of Immunopathology, Sanquin, Amsterdam, The Netherlands
  1. Correspondence to Erik Hans Vogelzang, Department of Rheumatology, Jan van Breemen Research Institute | Reade, Dr Jan van Breemenstraat 2, Amsterdam 1056 AB, The Netherlands; e.vogelzang{at}


Objectives To investigate the relationship between antidrug antibodies (ADA), adalimumab concentrations and clinical response in patients with psoriatic arthritis (PsA) during 52 weeks of follow-up.

Methods This prospective cohort study included 103 consecutive patients with PsA. Disease Activity Score of 28 joints (DAS28), Erythrocyte Sedimentation Rate, C reactive protein and Psoriasis Area and Severity Index were assessed. Adalimumab concentrations and ADA were measured in serum trough samples, using an ELISA and a radio immunoassay, respectively.

Results Adalimumab concentrations were significantly lower at 28 and 52 weeks in patients with detectable ADA compared with patients without detectable ADA (at week 28: 1.3 mg/L (IQR 0.0–3.2) versus 8.7 mg/L (IQR 5.7–11.5), p<0.001; at week 52: 0.9 mg/L (IQR 0.0–2.9) vs 9.4 mg/L (IQR 5.7–12.1), p=0.0001). DAS28 at 28 weeks (2.16 vs 2.95, p=0.023) and 52 weeks (2.19 vs 2.95, p=0.024) showed a significant difference; patients with detectable ADA had a poorer clinical outcome than patients without.

Conclusions Patients with detectable ADA had lower adalimumab concentrations and a significantly poorer clinical outcome compared with patients in whom ADA were not detected.

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