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Psoriasis patients likely to develop antidrug antibody to adalimumab within first 24 weeks
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Patients with plaque psoriasis had the greatest chance of developing antidrug antibody to adalimumab in the first 24 weeks of treatment, according to recent study results.
Researchers conducted an extension to a cohort study of 29 patients with plaque-type psoriasis who were followed up for 24 weeks of treatment. Antidrug antibody (ADA) to adalimumab was observed in 45% of the cohort. The extension study at outpatient dermatology clinics at two academic hospitals in the Netherlands included the original cohort and 51 additional patients (mean age, 46 years; 52 men) who received adalimumab and were followed for 1 year.
Psoriasis Area and Severity Index (PASI) and personnel analyzing serum samples were measured by independent assessors who were unaware of the presence of ADA to adalimumab or the adalimumab serum concentration at baseline and at weeks 12, 24 and 52. Patient PASI and adalimumab and ADA concentrations were the main outcomes and measures.
Researchers observed antidrug antibody in 49% of patients during the extension study, with 90% of them displaying ADA formation by week 24.
Adalimumab and ADA concentrations had a correlation of –0.872, while clinical response and ADA concentration had a correlation of –0.606. Adalimumab concentration and clinical response displayed a moderately strong correlation coefficient of 0.519.
Fifteen patients (seven with ADA) received dose interval shortening because of lack of efficacy. One patient with ADA displayed improved response, while four of the non-ADA patients showed improvement in responder status.
“Our findings show that the biggest chance of first-time ADA development is in the first 24 weeks of treatment (35 vs. four patients) and further support the notion that the presence of ADA is strongly correlated with adalimumab level and greatly influences clinical response, also after 24 weeks of treatment,” the researchers concluded. “Dose interval shortening might be useful if no ADAs are present, but it seems less useful if they are present.”
Disclosure: See the study for a full list of relevant financial disclosures.
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