Skip to main content
Log in

Drug levels, immunogenicity and assessment of active sacroiliitis in patients with axial spondyloarthritis under biologic tapering strategy

  • Short Communication - Observational Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of the study was to assess drug levels, immunogenicity and sacroiliitis on MRI in patients with axial spondyloarthritis under biologic tapering strategy. Consecutive patients with axial spondyloarthritis who remained in low disease activity more than 1 year after dose tapering of infliximab and adalimumab were included. Plasma drug concentrations of TNF inhibitors and anti-drug antibodies were determined, and MRI of sacroiliac joints was evaluated. Of twenty patients included, eighteen had therapeutic drug levels, no patient had anti-drug antibodies, and no patient had active sacroiliitis on MRI. These data could support the biologic tapering strategy and their maintenance over time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W et al (2002) Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial. Lancet 359:1187–1193

    Article  CAS  PubMed  Google Scholar 

  2. Van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J et al (2006) Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 54:2136–2146

    Article  PubMed  Google Scholar 

  3. Sieper J, van der Heijde D, Dougados M, Mease PJ, Maksymowych WP, Brown MA et al (2013) Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1). Ann Rheum Dis 72:815–822

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Navarro-Compán V, Moreira V, Ariza-Ariza R, Hernández-Cruz B, Vargas-Lebrón C, Navarro-Sarabia F (2011) Low doses of etanercept can be effective in ankylosing spondylitis patients who achieve remission of the disease. Clin Rheumatol 30:993–996

    Article  PubMed  Google Scholar 

  5. Paccou J, Baclé-Boutry MA, Solau-Gervais E, Bele-Philipe P, Flipo RM (2012) Dosage adjustment of anti-tumor necrosis factor-α inhibitor in ankylosing spondylitis is effective in maintaining remission in clinical practice. J Rheumatol 39:1418–1423

    Article  CAS  PubMed  Google Scholar 

  6. Závada J, Uher M, Sisol K, Forejtová S, Jarošová K, Mann H et al (2016) A tailored approach to reduce dose of anti-TNF drugs may be equally effective, but substantially less costly than standard dosing in patients with ankylosing spondylitis over 1 year: a propensity score-matched cohort study. Ann Rheum Dis 75:96–102

    Article  PubMed  Google Scholar 

  7. Plasencia C, Kneepkens EL, Wolbink G, Krieckaert CL, Turk S, Navarro-Compán V et al (2015) Comparing tapering strategy to standard dosing regimen of tumor necrosis factor inhibitors in patients with spondyloarthritis in low disease activity. J Rheumatol 42:1638–1646

    Article  PubMed  Google Scholar 

  8. Kneepkens EL, Wei JC, Nurmohamed MT, Yeo KJ, Chen CY, van der Horst-Bruinsma IE et al (2015) Immunogenicity, adalimumab levels and clinical response in ankylosing spondylitis patients during 24 weeks of follow-up. Ann Rheum Dis 74:396–401

    Article  CAS  PubMed  Google Scholar 

  9. Arends S, Lebbink HR, Spoorenberg A, Bungener LB, Roozendaal C, van der Veer E et al (2010) The formation of autoantibodies and antibodies to TNF-α blocking agents in relation to clinical response in patients with ankylosing spondylitis. Clin Exp Rheumatol 28:661–668

    CAS  PubMed  Google Scholar 

  10. de Vries MK, van der Horst-Bruinsma IE, Nurmohamed MT, Aarden LA, Stapel SO, Peters MJ et al (2009) Immunogenicity does not influence treatment with etanercept in patients with ankylosing spondylitis. Ann Rheum Dis 68:531–535

    Article  PubMed  Google Scholar 

  11. Lambert RG, Salonen D, Rahman P, Inman RD, Wong RL, Einstein SG et al (2007) Adalimumab significantly reduces both spinal and sacroiliac joint inflammation in patients with ankylosing spondylitis: a multicenter, randomized, double-blind, placebo-controlled study. Arthritis Rheum 56:4005–4014

    Article  CAS  PubMed  Google Scholar 

  12. Pedersen SJ, Sørensen IJ, Hermann KG, Madsen OR, Tvede N, Hansen MS et al (2010) Responsiveness of the ankylosing spondylitis disease activity score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor alpha inhibitors. Ann Rheum Dis 69:1065–1071

    Article  PubMed  Google Scholar 

  13. Maksymowych WP, Salonen D, Inman RD, Rahman P, Lambert RG, CANDLE Study Group (2010) Low-dose infliximab (3 mg/kg) significantly reduces spinal inflammation on magnetic resonance imaging in patients with ankylosing spondylitis: a randomized placebo-controlled study. J Rheumatol 37:1728–1734

    Article  CAS  PubMed  Google Scholar 

  14. Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J et al (2009) The development of Assessment of spondyloarthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783

    Article  CAS  PubMed  Google Scholar 

  15. Ruiz-Argüello B, del Agua AR, Torres N, Monasterio A, Martínez A, Nagore D (2013) Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels. Clin Chem Lab Med 51:287–289

    Article  Google Scholar 

  16. Rudwaleit M, Jurik AG, Hermann KG, Landewé R, van der Heijde D, Baraliakos X et al (2009) Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis 68:1520–1527

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miriam Almirall.

Ethics declarations

Conflict of interest

The authors declare that they have no other conflict of interest.

Ethical approval

The study was approved by the local ethics committee.

Informed consent

Informed consent was obtained from all individual patients included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Almirall, M., Gimeno, R., Salman-Monte, T.C. et al. Drug levels, immunogenicity and assessment of active sacroiliitis in patients with axial spondyloarthritis under biologic tapering strategy. Rheumatol Int 36, 575–578 (2016). https://doi.org/10.1007/s00296-016-3428-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-016-3428-0

Keywords

Navigation