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Golimumab trough levels, antidrug antibodies and clinical response in patients with rheumatoid arthritis treated in daily clinical practice
  1. Eva L Kneepkens1,
  2. Chamaida Plasencia2,
  3. Charlotte LM Krieckaert1,
  4. Dora Pascual-Salcedo3,
  5. Desiree van der Kleij4,
  6. Michael T Nurmohamed1,5,
  7. M Teresa López-Casla2,
  8. Roeland Wieringa4,
  9. Theo Rispens6,
  10. Gertjan Wolbink1,6
  1. 1 Department of Rheumatology, Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands
  2. 2 Department of Rheumatology, La Paz University Hospital, Madrid, Spain
  3. 3 Immunology Unit, La Paz University Hospital, Madrid, Spain
  4. 4 Sanquin Diagnostic Services, Amsterdam, The Netherlands
  5. 5 Department of Rheumatology, VU University medical centre, Amsterdam, The Netherlands
  6. 6 Department of Immunopathology, Sanquin Research and Landsteiner Laboratory Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Eva-Linda Kneepkens, Department of Rheumatology, Jan van Breemen Research Institute | Reade, Dr Jan van Breemenstraat 2, Amsterdam 1056 AB, The Netherlands; e.kneepkens{at}

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Tumour necrosis factor inhibitors (TNFi) are effective in the majority of patients with rheumatoid arthritis (RA),1 however, an important reason for non-response is low drug level due to immunogenicity.2 To our knowledge, no data collected during a prospective observational study is currently available regarding the relationship between golimumab level, immunogenicity and response in RA.

This prospective observational cohort consisted of 37 consecutive adult patients with RA, according to the American College of Rheumatology 1987 revised criteria,3 in whom golimumab 50 mg subcutaneously once monthly was initiated according to the judgment of the rheumatologist, and who were recruited from two departments (Spain and The Netherlands). The study was approved by both Medical Ethics Committees. Clinical response was defined as Disease Activity Score using 28 joint count (DAS28) <3.2, calculated with erythrocyte sedimentation rate (ESR) (mm/h). Patients were eligible for inclusion when clinical data and sera of baseline with ≥ one follow-up visit were available.

Clinical measurements and trough-level sera were collected at baseline and 4, 16, 28 and 52 weeks (The Netherlands), or half yearly (Spain), thereafter. Golimumab levels were measured analogously to adalimumab4 using TNF for capture and rabbit antigolimumab for detection …

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