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Response to: Comment on l’Ami et al titled ‘Successful reduction of overexposure in patients with rheumatoid arthritis with high serum adalimumab concentrations: an open-label, non-inferiority, randomised clinical trial’ by den Broeder et al
  1. Merel J l’Ami1,
  2. Charlotte L M Krieckaert1,2,
  3. Michael T Nurmohamed2,
  4. Ronald F van Vollenhoven3,
  5. Theo Rispens4,
  6. Maarten Boers5,
  7. Gerrit Jan Wolbink1
  1. 1 Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
  2. 2 Department of Reumatology, Amsterdam Rheumatology and immunology Center, Location VU University Medical Center, Amsterdam, The Netherlands
  3. 3 Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Location Amsterdam Medical Center, Amsterdam, The Netherlands
  4. 4 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
  5. 5 Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam, The Netherlands
  1. Correspondence to Merel J l’Ami, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam 1056 AB, The Netherlands ; m.lami{at}reade.nl

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We thank den Broeder et al for their interest in our study and for their suggestions concerning further research.1 Our study did not target the broad issue of dose tapering, but focused on the population of patients with rheumatoid arthritis with high adalimumab concentrations (>8 µg/mL).2 We hypothesised that given the wide variation in serum concentrations on standard dosing and the established plateau in the concentration–response relationship—even in active disease3—there would be a role for individualised dosing to optimise adalimumab therapy. Unlike den Broeder et al, we find nothing peculiar about our research question or design …

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Footnotes

  • Handling editor Josef S Smolen

  • Contributors All authors have made substantial contributions to the conception, drafting and revising of the work, and all approved the final version and are accountable for all aspects of the work.

  • Funding GJW has received research funding from Pfizer and honoraria for lectures and in advisory boards of Pfizer, UCB, BMS, AbbVie, Novartis and Biogen.

  • Competing interests CLK has received honoraria for lectures from Pfizer and MTN has received research funding or speaking/consultancy honoraria from AbbVie, Pfizer, Merck, Roche, BMS, UCB, Eli Lilly, Celgene and Janssen. RvV has received research support and grants from AbbVie, Amgen, BMS, GSK, Pfizer, Roche, UCB and honoraria for consultancy from AbbVie, Biotest, BMS, Celgene, Crescendo, GSK, Janssen, Lilly, Merck, Novartis, Pfizer, Roche, UCB and Vertex. TR has received honoraria for lectures from Pfizer, AbbVie and Regeneron and a research grant from Genmab. MB has received consultancy for Pfizer, BMS, UCB and Teva.

  • Provenance and peer review Commissioned; internally peer reviewed.

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