Behandling af reumatoid artrit med anti-tumornekrosefaktor-alpha-antistof. Individuel monitorering af biotilgaengelighed og immunogenicitet-- sekundaerpublikation

• Remicade/infliximab is effective in rheumatoid arthritis (RA), but response failure is frequent. Sera from 106 RA patients were monitored using an RIA for functional infliximab and an RIA for anti-infliximab antibody (Ab). S-infliximab varied considerably, e.g. 0-22 microg/ml before the 3rd infusion, and 44% were Ab-positive after 6 months. Low s-infliximab was associated with Ab development and later therapeutic failure, and high Ab levels could be related to dose increases, side-effects and cessation of therapy. Pharmacological monitoring should help optimize anti-TNF therapies.

• Abstract in Danish Infliximab er effektiv ved reumatoid artritis (RA), men behandlingssvigt er hyppige. Sera fra 106 RA-patienter monitoreredes med en radioimmunoassay (RIA) for funktionel infliximab og en RIA for anti-infliximab-antistof. S-infliximab varierede betydeligt, f.eks. 0-22 μg/ml forud for tredje infusion, og efter seks måneder var 44% antistofpositive. Lav S-infliximab var forbundet med antistofudvikling og senere terapisvigt, og høje antistofniveauer kunne relateres til dosisøgning, bivirkninger og terapiophør. Farmakologisk monitorering kan formentlig optimere behandlinger med anti-tumornekrose-antistof.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

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