摘要：

目的：评估阿达木单抗抗体在类风湿性关节炎(RA),强直性脊柱炎(AS)和银屑病关节炎(PsA)在临床/实验室中的相关重要性。

方法：记录并评估58例类风湿性关节炎(RA),强直性脊柱炎(AS)和银屑病关节炎(PsA)患者在使用阿达木单抗治疗4、12、24周后的临床/实验室特征、病情发展情况、ADA抗体、ANA、抗dsDNA、抗ENA和PL抗体的基线。

结果：在观察11/58（19%）患者的ADA抗体中发现经4周治疗后90.9%为阳性。ADA抗体阳性与显著降低的ADA血清浓度水平相关（P<0 .05）。在观察治疗失败的20/58(34.5%)患者中发现与ada抗体显著相关（p<0.05）。意味着治疗失败患者中的ada血清水平比疗效良好者、整个受试对象(p<0.01) 、ada抗体阳性患者显著降低(p<0.01)。ada抗体阳性患者不良事件的发生率高于阴性患者(27.3% vs 14.9%)。

结论：抗阿达木单抗抗体是提示阿达木单抗疗效不佳的早期标志物。常规ANA、抗ENA和抗磷脂抗体检测不能预测抗阿达木单抗抗体的存在。

附原文：AbstractOBJECTIVES:To evaluate the relevance of anti-adalimumab (anti-ADA) antibodies (Abs) and their relationship with clinical/laboratory features in rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA).METHODS:Fifty-eight patients affected with RA, AS and PsA were prospectively enrolled. Clinical/laboratory characteristics, disease activity, anti-ADA, anti-nuclear (ANA), anti-double strand (ds)DNA, anti-extractable nuclear antigens (anti-ENA) and anti-phospholipid Abs (aPL) were evaluated at baseline, 4, 12 and 24 weeks of adalimumab treatment.RESULTS:Anti-ADA Abs were observed in 11/58 (19%) patients; they were detected within the 4th week of therapy in 90.9% of the positive subjects. Anti-ADA positivity was associated with significantly lower mean adalimumab serum levels (P<0 .05). treatment failure was observed in 20/58 (34.5%) patients and was significantly associated with anti-ada abs (p<0.05). mean adalimumab serum levels were significantly lower in patients with treatment failure than in the responders one, both in the whole cohort (p<0.01) and in the group of anti-ada positive patients (p<0.01). adverse events happened more often in anti-ada positive then in anti-ada negative patients (27.3% vs 14.9%).conclusions:anti-ada abs could be considered an early marker associated to a poor clinical response to adalimumab treatment. routine ana/anti-ena/apl monitoring did not reveal as useful tools to predict the development of anti-ada abs.

引自：Hoxha A¹, Calligaro A², Tonello M², Ramonda R², Carletto A³, Paolazzi G⁴, Bortolotti R⁴, Del Ross T², Grava C⁵, Boaretto M⁵, Favaro M², Teghil V², Ruffatti A², Punzi L². The clinical relevance of early anti-adalimumab antibodies detection in rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: A prospective multicentre study. Joint Bone Spine. 2016 Mar;83(2):167-71. doi: 10.1016/j.jbspin.2015.04.020. Epub 2015 Dec 29.