Division of Rheumatology and Clinical Immunology, Jichi Medical University, 3311 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Mod Rheumatol. 2012 Aug;22(4):532-40. doi: 10.1007/s10165-011-0567-8. Epub 2011 Dec 16.
We investigated the influence of antibodies against infliximab and etanercept on the serum trough levels of these agents and the influence of these antibodies on the effectiveness of treatment in patients with rheumatoid arthritis treated with these agents. Forty patients treated with infliximab for 54 weeks and 40 patients treated with etanercept for 32 weeks were enrolled. They were divided into responder and non-responder groups. Serum trough levels of and antibodies against these agents were measured by enzyme-linked immunosorbent assay or radioimmunoassay. Of the 40 patients treated with infliximab, 14 (35%) had anti-infliximab antibodies. Serum trough levels were significantly lower in the non-responder group (14 patients) than in the responder group (26 patients) 6 weeks after initiation of infliximab (p < 0.05). Conversely, titers of anti-infliximab antibody were significantly higher in the non-responder group than in the responder group between 6 and 38 weeks after initiation of infliximab (p < 0.05). Anti-etanercept antibodies were not detected in any patients on etanercept. Serum trough levels of etanercept were not significantly different between the responder (31 patients) and non-responder groups (9 patients). It seems that the appearance of anti-infliximab antibodies might decrease infliximab serum concentrations and, thereby, reduce the agent's effectiveness. The clinical efficacy of etanercept does not appear to be affected by the serum concentrations if it is administered at standard doses.
我们研究了针对英夫利昔单抗和依那西普的抗体对这些药物血清谷浓度的影响，以及这些抗体对接受这些药物治疗的类风湿关节炎患者治疗效果的影响。纳入了 40 例接受英夫利昔单抗治疗 54 周和 40 例接受依那西普治疗 32 周的患者。他们被分为应答者和非应答者组。采用酶联免疫吸附试验或放射免疫分析法测定这些药物的血清谷浓度和抗体。在接受英夫利昔单抗治疗的 40 例患者中，有 14 例（35%）产生了抗英夫利昔单抗抗体。在英夫利昔单抗治疗开始后 6 周，非应答者组（14 例）的血清谷浓度明显低于应答者组（26 例）（p<0.05）。相反，在英夫利昔单抗治疗开始后 6 至 38 周，非应答者组的抗英夫利昔单抗抗体滴度明显高于应答者组（p<0.05）。在接受依那西普的患者中均未检测到抗依那西普抗体。应答者组（31 例）和非应答者组（9 例）的依那西普血清谷浓度无显著差异。似乎抗英夫利昔单抗抗体的出现可能会降低英夫利昔单抗的血清浓度，从而降低药物的疗效。如果以标准剂量给予依那西普，其临床疗效似乎不受血清浓度的影响。
