The effect of immunomodulators on the immunogenicity of TNF-blocking therapeutic monoclonal antibodies: a review |
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Authors: | Charlotte Louise Maria Krieckaert Geertje Margret Bartelds Willem Frederik Lems Gerrit Jan Wolbink |
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Institution: | Department of Rheumatology, Jan van Breemen Institute, Dr Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands. c.krieckaert@janvanbreemen.nl |
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Abstract: | Therapeutic monoclonal antibodies have revolutionized the treatment of various inflammatory diseases. Immunogenicity against
these antibodies has been shown to be clinically important: it is associated with shorter response duration because of diminishing
concentrations in the blood and with infusion reactions. Concomitant immunomodulators in the form of methotrexate or azathioprine
reduced the immunogenicity of therapeutic antibodies in rheumatoid arthritis, Crohn disease, and juvenile idiopathic arthritis.
The occurrence of adverse events does not increase when immunomodulators are added to therapeutic antibodies. The mechanism
whereby methotrexate and azathioprine influence immunogenicity remains unclear. Evidence-based consensus on prescribing concomitant
immunomodulators is needed. |
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