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Several factors—including immunogenicity—influence pharmacokinetics of adalimumab. The formation of antidrug antibodies (ADAb) leads to lower adalimumab trough concentrations in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA),1 ,2 and thus associated with a diminished clinical response.3 A previous paper demonstrated that methotrexate (MTX) had a dose-dependent effect on the percentage of patients that tested positive for ADAb against adalimumab.4 Moreover, prior research has shown that patients with RA concomitantly treated with MTX had higher adalimumab trough concentrations than patients without, which was also dose dependent, resulting in a more frequently achieved European League Against Rheumatism good response status.5 ,6 These studies suggest an additional beneficial effect of concomitant MTX therapy for patients with RA treated with adalimumab. However, in PsA, the benefit of MTX is not yet clear.7 Also, some patients do …
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