Rheumatology AdvisorAntidrug Antibodies Associated with Biologic Drug Response in Rheumatoid Arthritis

New Study Emphasizes the Importance of Monitoring Antidrug Antibodies in Rheumatoid Arthritis Patients Undergoing bDMARD Therapy

A recent study published in JAMA Network Open reveals a significant correlation between antidrug antibodies and the ineffectiveness of biologic disease-modifying antirheumatic drugs (bDMARDs) in treating rheumatoid arthritis (RA). The findings underscore the need for healthcare professionals to monitor these antibodies, especially in patients who are not responding to treatment.

HCN Medical Memo
This study highlights the critical role of monitoring antidrug antibodies in patients undergoing bDMARD therapy. The presence of these antibodies is significantly associated with a lack of response to treatment, making their monitoring an essential part of patient management, particularly for those not responding to current regimens.

Key Points

• The study assessed 230 adult patients with RA who were initiating a new bDMARD treatment.
• At the 12-month mark, 38.2% of patients treated with anti-TNF mAbs tested positive for antidrug antibodies.
• An inverse relationship was found between antidrug antibody positivity and EULAR response at 12 months for all bDMARDs (OR, 0.19; 95% CI, 0.09-0.38; P <.001).
• Other factors inversely associated with treatment response included a body mass index of at least 25 kg/m^2 and rheumatoid factor positivity.

“Findings of this study suggest that antidrug antibodies are associated with nonresponse to biologic drugs in RA and can be monitored in the management of patients with RA, particularly nonresponders.”
– Study Authors

Additional Points

• The study was underpowered to demonstrate associations for each drug individually.
• A large proportion of patients were missing antidrug antibody measurements.
• Secondary study endpoints were not corrected for multiple tests.

More on Rheumatoid Arthritis (RA)