Influence of rheumatoid factor levels and TNF inhibitor structure on secondary nonresponse in rheumatoid arthritis patients.

Autor:	Plasencia-Rodríguez C; Rheumatology Department, La Paz University Hospital, Madrid, Spain.; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain., Martínez-Feito A; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain.; Immunology Unit, La Paz University Hospital, Madrid, Spain., Novella-Navarro M; Rheumatology Department, La Paz University Hospital, Madrid, Spain.; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain., Pérez De Diego R; Laboratory of Immunogenetics of Human Diseases, IdiPAZ Institute for Health Research, La Paz University Hospital, Madrid, Spain.; Innate Immunity Group, IdiPAZ Institute for Health Research, La Paz University Hospital, Madrid, Spain.; Interdepartmental Group of Immunodeficiencies, Madrid, Spain., Bonilla G; Rheumatology Department, La Paz University Hospital, Madrid, Spain.; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain., Gehin JE; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway., Villalba-Yllán A; Rheumatology Department, La Paz University Hospital, Madrid, Spain., Nuño L; Rheumatology Department, La Paz University Hospital, Madrid, Spain., Pascual-Salcedo D; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain., Nozal P; Immunology Unit, La Paz University Hospital, Madrid, Spain.; Center for Biomedical Network Research on Rare Diseases (CIBERER U754), Madrid, Spain., Almirón MD; Biostatistics Unit, Institute for Health Research (IdiPAZ), Madrid, Spain., Balsa A; Rheumatology Department, La Paz University Hospital, Madrid, Spain.; Immuno-Rheumatology Research Group, Institute for Health Research (IdiPAZ), Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2024 Sep 04; Vol. 11, pp. 1461396. Date of Electronic Publication: 2024 Sep 04 (Print Publication: 2024).
DOI:	10.3389/fmed.2024.1461396
Abstrakt:	Background: The EXXELERATE study revealed poorer clinical outcomes in patients treated with adalimumab (ADL) and baseline rheumatoid factor (RF) above 203 IU/mL. However, responses were similar in patients treated with certolizumab pegol (CZP) regardless of RF levels. Objectives: This study investigated the impact of RF levels >203 IU/mL on TNF inhibitors (TNFi) serum levels and the association with secondary nonresponse in RA patients treated with TNFi. Methods: We performed an observational ambispective study with RA patients treated with infliximab (IFX), ADL, or CZP. Patients were stratified according to baseline RF levels: ≤ or >203 IU/mL. After 6 months, serum drug levels and antidrug antibodies were measured, and reasons for discontinuation were collected. Results: We included 170 RA patients: 90 (53%) received IFX, 48 (28%) ADL, and 32 (19%) CZP. While CZP serum levels did not differ between RF groups at 6 months ( p  = 0.6), RF levels >203 IU/mL were linked to lower serum drug levels in patients treated with IFX ( p  = 0.09) or ADL ( p  = 0.02). Secondary nonresponse was 3.6 times higher in patients with high versus low RF levels in patients under IFX or ADL. However, the reasons for withdrawal were not affected by RF levels in patients treated with CZP. Conclusion: Baseline RF above 203 IU/mL is associated with lower serum drug levels and an increased risk of discontinuation due to secondary nonresponse in patients treated with IFX or ADL. In contrast, drug levels and clinical outcomes are not significantly impacted by baseline RF levels in patients under CZP. Competing Interests: CP-R has received research grants/honoraria from AbbVie, Pfizer, Novartis, Lilly, and Roche. MN-N has received research grants/honoraria from Galápagos, Janssen, Lilly, Novartis, and UCB. AB received grant/research support and fees for consultancies or as a speaker from AbbVie, Amgen, Pfizer, Novartis, BMS, Nordic, Sanofi, Sandoz, Lilly, UCB, and Roche. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Plasencia-Rodríguez, Martínez-Feito, Novella-Navarro, Pérez De Diego, Bonilla, Gehin, Villalba-Yllán, Nuño, Pascual-Salcedo, Nozal, Almirón and Balsa.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu