The effect of immunomodulators on the immunogenicity of TNF-blocking therapeutic monoclonal antibodies: a review

被引:106
作者
Krieckaert, Charlotte Louise Maria [1 ]
Bartelds, Geertje Margret [1 ]
Lems, Willem Frederik [2 ]
Wolbink, Gerrit Jan [1 ]
机构
[1] Jan van Breemen Inst, Dept Rheumatol, NL-1056 AB Amsterdam, Netherlands
[2] Vrije Univ Amsterdam Med Ctr, Dept Rheumatol, NL-1007 MB Amsterdam, Netherlands
关键词
RHEUMATOID-ARTHRITIS PATIENTS; DECREASED CLINICAL-RESPONSE; ANTI-ADALIMUMAB ANTIBODIES; CROHNS-DISEASE; ANKYLOSING-SPONDYLITIS; MAINTENANCE INFLIXIMAB; METHOTREXATE; COMBINATION; EFFICACY;
D O I
10.1186/ar3147
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Therapeutic monoclonal antibodies have revolutionized the treatment of various inflammatory diseases. Immunogenicity against these antibodies has been shown to be clinically important: it is associated with shorter response duration because of diminishing concentrations in the blood and with infusion reactions. Concomitant immunomodulators in the form of methotrexate or azathioprine reduced the immunogenicity of therapeutic antibodies in rheumatoid arthritis, Crohn disease, and juvenile idiopathic arthritis. The occurrence of adverse events does not increase when immunomodulators are added to therapeutic antibodies. The mechanism whereby methotrexate and azathioprine influence immunogenicity remains unclear. Evidence-based consensus on prescribing concomitant immunomodulators is needed.
引用
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页数:6
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