RESEARCH - Anti-infliximab antibodies in patients with RA who require higher doses of Remicade

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J Rheumatol. 2006 Jan;33(1):31-6.

Anti-infliximab antibodies in patients with rheumatoid arthritis who require

higher doses of infliximab to achieve or maintain a clinical response.

Haraoui B, Cameron L, Ouellet M, White B.

From the Department of Rheumatology, Centre Hospitalier de l'Universite de

Montreal, and Groupe de recherche des maladies rhumatismales du Quebec,

Montreal, Quebec, Canada; and Amgen Inc., Thousand Oaks, California, USA.

OBJECTIVE: To determine whether the need to use doses of infliximab greater

than 3 mg/kg every 8 weeks to achieve or maintain clinical response in

patients with rheumatoid arthritis (RA) is associated with differences in

baseline clinical characteristics or anti-infliximab antibodies. METHODS:

Baseline clinical characteristics and anti-infliximab levels were evaluated

retrospectively in a cohort of 51 consecutive patients with RA treated with

infliximab at a single center. Patients were divided into 2 groups for

comparison: Group 1 patients achieved and maintained clinical responses with

infliximab 3 mg/kg every 8 weeks; Group 2 patients required higher doses.

RESULTS: Thirty-two (63%) patients required infliximab dose escalation

(Group 2). There were no statistically significant differences in baseline

or clinical characteristics between Group 1 and Group 2 patients.

Anti-infliximab antibodies occurred in 47% of Group 2 versus 27% of Group 1

patients, with higher anti-infliximab antibody concentrations in Group 2

patients (mean +/- SD: 18.3 +/- 8.9 g/ml vs 7.5 +/- 4.8 g/ml; p = 0.02).

Patients who developed anti-infliximab antibodies were younger and receiving

less prednisone at the time of infliximab initiation than patients who did

not.

CONCLUSION: Finding higher anti-infliximab antibody concentrations in

patients who needed dose escalation of infliximab to achieve or maintain

clinical responses with lower serum trough levels of infliximab suggests

that development of anti-infliximab antibodies may reduce clinical efficacy

of infliximab in some patients with RA.

PMID: 16395747

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6395747 & dopt=Abstract

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