Serum etanercept concentrations in relation to disease activity and treatment response assessed by ultrasound, biomarkers and clinical disease activity scores: results from a prospective observational study of patients with rheumatoid arthritis
| Autor: | Johanna Elin Gehin, Silje Watterdal Syversen, David John Warren, Guro Løvik Goll, Joseph Sexton, Nils Bolstad, Hilde Berner Hammer |
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| Rok vydání: | 2021 |
| Předmět: |
rheumatoid arthritis
musculoskeletal diseases tumor necrosis factor inhibitors Immunology Treatments Ultrasonography Doppler Arthritis Rheumatoid stomatognathic diseases Rheumatology immune system diseases Antirheumatic Agents Humans Immunology and Allergy skin and connective tissue diseases etanercept pharmacokinetics Biomarkers |
| Zdroj: | RMD Open |
| ISSN: | 2056-5933 |
| Popis: | ObjectivesTo identify the therapeutic range for etanercept and to assess the incidence of anti-etanercept antibody formation.MethodsAssociations between etanercept serum concentration and disease activity as well as treatment response were examined in a longitudinal observational study of rheumatoid arthritis patients starting etanercept. Disease activity was assessed by ultrasound (grey scale and power Doppler), 28-joint Disease Activity Score (DAS28), Simplified Disease Activity Index, plasma calprotectin and C reactive protein. Etanercept concentration and anti-etanercept antibodies were analysed using automated in-house fluorescence assays.ResultsA total of 89 patients were included, whereof 66% were biological disease-modifying antirheumatic drug (DMARD) naïve and 91% used concomitant synthetic DMARD. At 3 months, the median etanercept concentration was 1.8 (IQR 1.1–2.5) mg/L. Longitudinal associations were found between etanercept concentration and disease activity assessed by plasma calprotectin, C reactive protein and DAS28, but not between etanercept concentration and improvement in disease activity by any of the parameters at 3, 6 or 12 months of treatment. Etanercept concentrations were not significantly different among patients who achieved response or remission, compared with non-response or non-remission. Hence, no therapeutic range could be identified. None of the patients developed anti-etanercept antibodies.ConclusionDespite the use of sensitive and objective markers of inflammation, a therapeutic range could not be identified for etanercept. Hence, this study suggests that proactive therapeutic drug monitoring is unlikely to benefit rheumatoid arthritis patients treated with etanercept, but a potential benefit in certain clinical situations cannot be excluded. |
| Databáze: | OpenAIRE |
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