Circulating cell-free DNA levels in Portuguese patients with psoriasis vulgaris according to severity and therapy

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Coimbra, S (Author) Other; Catarino, C (Author) FFUP; Costa, E (Author) FFUP; Oliveira, H (Author) Other; Figueiredo, A (Author) Other; Rocha Pereira, P (Author) Other; Santos Silva, A (Author) FFUP

Journal

Title: British Journal of Dermatology

Vol. 170

Pages: 939-942

ISSN: 0007-0963

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 8 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-009-GHG

DOI: 10.1111/bjd.12738

Abstract (EN): BackgroundCurrent treatment with biologics has produced dramatic therapeutic effects in patients with psoriasis, although these agents occasionally decrease in efficacy. One of the main factors responsible for this attenuation is attributed to the development of antidrug antibodies (ADAs). ObjectivesTo analyse the relationship between serum drug concentrations, the presence of ADAs and treatment efficacy of adalimumab and infliximab, and to determine the optimal use of these biologics. MethodsThis was a 1-year prospective study in the dermatology departments of Kobe University Hospital and collaborating hospitals. All patients starting a regimen of adalimumab and infliximab for psoriasis were included. We measured the serum concentration of the drugs and titres of antibodies to adalimumab and infliximab, as well as the Psoriasis Area and Severity Index scores at weeks 0, 4, 12, 24 and 48 during the first year of treatment. ResultsWe observed a 50% positive rate of ADAs to adalimumab, and a 41% positive rate of ADAs to infliximab. The titres of ADAs showed a wide range from low to high titres. In the high-titre groups, the patients exhibited a decreased clinical response, and demonstrated a negative correlation between titre and clinical response. However, an equivalent therapeutic effect was observed between the low-titre group and the group with no antibodies detected for adalimumab. For infliximab, the patients with ADAs showed decreased clinical response. An apparent negative correlation between antibody production and reduced clinical response was observed. ConclusionsTwo biologics, adalimumab and infliximab, showed different therapeutic behaviour. The measurement of ADAs and drug concentrations has important implications for treatment with biologics. What's already known about this topic? <list list-type="bulleted" id="bjd12791-list-0001"> High frequent production of antidrug antibodies (ADAs) has been observed in patients treated with biologics, and the production has caused impairment of treatment efficacy. What does this study add? <list list-type="bulleted" id="bjd12791-list-0002"> The optimal use of the biologics should be determined by the measurement of ADAs and each drug concentration in each patient because the standard protocol may not uniformly fit all patients.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 4