Addition of an Immunomodulator to Infliximab Therapy Eliminates Antidrug Antibodies in Serum and Restores Clinical Response of Patients With Inflammatory Bowel Disease

作者：Ben-Horin, Shomron^*; Waterman, Matti; Kopylov, Uri; Yavzori, Miri; Picard, Orit; Fudim, Ella; Awadie, Halim; Weiss, Batia; Chowers, Yehuda

来源：Clinical Gastroenterology and Hepatology, 2013, 11(4): 444-447.

DOI：10.1016/j.cgh.2012.10.020

• ADA
• IBD
• Crohn's Disease
• Ulcerative Colitis

There are few therapeutic options for patients with inflammatory bowel disease who lose response to infliximab because they produced antibodies against the drug. We performed a retrospective analysis to investigate whether administration of immune modulators to 5 patients who developed antibodies to infliximab (ATI) restored response to this drug; 3 patients were given azathioprine/6-mercaptopurine and 2 patients were given methotrexate. Concentrations of infliximab and ATIs, and antitumor necrosis factor (TNF) activity, were analyzed using enzyme-linked immunosorbent assay-based competition assays of serum samples collected before and after patients were given the immunomodulator. In all patients, levels of ATIs gradually decreased and trough levels of infliximab increased; clinical responses were restored to all patients. In competition assays, immunomodulator-induced elimination of ATIs was associated with increased anti-TNF activity in serum. The addition of immunomodulators to therapy might be helpful to patients who have lost response to anti-TNF agents owing to formation of antidrug antibodies.

• 出版日期2013-4