| Texto completo | |
| Autor(es): Mostrar menos - |
Pimentel, Clarissa Q.
;
Medeiros-Ribeiro, Ana Cristina
;
Shimabuco, Andrea Y.
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Sampaio-Barros, Percival D.
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Moraes, Julio Cesar B.
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Schainberg, Claudia G.
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Goncalves, Celio Roberto
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Leon, Elaine P.
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Kupa, Leonard De Vinci K.
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Pasoto, Sandra G.
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Aikawa, Nadia E.
;
Silva, Clovis A.
;
Bonfa, Eloisa
;
Saad, Carla G. S.
Número total de Autores: 14
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| Tipo de documento: | Artigo Científico |
| Fonte: | ARTHRITIS & RHEUMATOLOGY; v. 76, n. 10, p. 13-pg., 2024-07-14. |
| Resumo | |
Objective. The aim of this study was to evaluate the influence of anti-infliximab (IFX) antibodies on three different points of care: response/tolerance to IFX, tapering strategy, and in a subsequent treatment with a second tumor necrosis factor inhibitor (TNFi). Methods. A prospective cohort of 60 patients with radiographic axial spondyloarthritis who received IFX were evaluated retrospectively regarding clinical/laboratorial data, IFX levels, and anti-IFX antibodies at baseline, after 6, 12 to 14, 22 to 24, 48 to 54, 96 to 102 weeks, and before tapering or switching. Results. Anti-IFX antibodies were detected in 27 patients (45%), of whom 23 (85.1%) became positive in the first year of IFX treatment. In comparison to the group that was negative for anti-IFX antibodies, patients who were positive for anti-IFX antibodies demonstrated the following: less use of methotrexate as a concomitant treatment to IFX (5 [18.5%] vs 14 [42.4%]; P = 0.048), more infusion reactions at 22 to 24 weeks (P = 0.020) and 48 to 54 weeks (P = 0.034), more treatment failures (P = 0.028) at 48 to 54 weeks, reduced overall IFX survival (P < 0.001), and lower sustained responses (P = 0.044). Of note, patients who were positive for anti-IFX antibodies exhibited a shorter tapering survival (9.9 months [95% confidence interval (CI) 4.0-15.8] vs 63.4 months [95% CI 27.9-98.8]; P = 0.004) in comparison with patients who were negative for anti-IFX antibodies. Conversely, for patients who failed IFX, patients who were positive for anti-IFX antibodies had better clinical response to the second TNFi at three months (15 [83.3%] vs 3 [27.3%]; P = 0.005) and six months (15 [83.3%] vs 4 [36.4%]; P = 0.017) than the patients who were negative for anti-IFX antibodies after switching. Conclusion. This study provided novel data that anti-IFX antibodies is a parameter for reduced tapering survival, reinforcing its detection to guide clinical decision. Additionally, we confirmed in a long-term cohort the anti-IFX antibody association with worse IFX performance and as predictor of the second TNFi good clinical response. (AU) | |
| Processo FAPESP: | 19/17272-0 - Avaliação da relevância dos níveis sanguíneos de drogas utilizadas em doenças autoimunes reumatológicas no acompanhamento da segurança, eficácia e aderência à terapêutica |
| Beneficiário: | Leonard de Vinci Kanda Kupa |
| Modalidade de apoio: | Bolsas no Brasil - Pós-Doutorado |