![]() Immunogenicity assessment of tumor necrosis factor antagonists in the clinical laboratory. Comparative immunogenicity of TNF inhibitors: impact on clinical efficacy and tolerability in the management of autoimmune diseases: a systematic review and meta-analysis. Thomas SS, Borazan N, Barroso N, et al.Assessing response and loss of response to biological therapies in IBD. Report of the ECCO pathogenesis workshop on anti-TNF therapy failures in inflammatory bowel diseases: definitions, frequency and pharmacological aspects. Efficacy of biological therapies in inflammatory bowel disease: systematic review and meta-analysis. ![]() American Gastroenterological Association Institute Guideline on therapeutic drug monitoring in inflammatory bowel disease. Feuerstein JD, Nguyen GC, Kupfer SS, et al.Guidelines of care for the management of psoriasis and psoriatic arthritis, section 1: overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. Menter A, Gottlieb A, Feldman SR, et al.2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Singh JA, Saag KG, Bridges SL Jr, et al.9 Development of anti-drug antibodies reduced the odds of clinical response by 67% overall, although nearly half of the data were derived from articles involving infliximab or adalimumab. In that study, anti-drug antibodies were detected more often in patients treated with infliximab (25%) than in those treated adalimumab (14%), certolizumab (6.9%), golimumab (3.8%), or etanercept (1.2%). The immunogenicity of TNF-alpha inhibitors (adalimumab, infliximab, etanercept, golimumab, and certolizumab) was investigated in a meta-analysis of 68 studies (14,651 patients) performed from 1966 to 2013. In patients with secondary failure, subtherapeutic drug levels may also be caused by the development of anti-drug antibodies that is, antibodies that target and lower the bioavailability of TNF-alpha inhibitors. In patients with primary treatment failure, subtherapeutic levels may indicate poor adherence or increased drug clearance, or other pharmacokinetic issues. Several factors can predispose to primary and secondary treatment failure.
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