| Title: |
Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis |
| Authors: |
Curry, Philippa D. K.; Hum, Ryan M.; Morris, Andrew P.; Jani, Meghna; Chinoy, Hector; Barton, Anne; Bluett, James |
| Source: |
Curry, P D K, Hum, R M, Morris, A P, Jani, M, Chinoy, H, Barton, A & Bluett, J 2023, 'Non-trough serum drug levels of adalimumab and etanercept are associated with response in patients with psoriatic arthritis', Rheumatology. https://doi.org/10.1093/rheumatology/kead666 |
| Publication Year: |
2023 |
| Collection: |
The University of Manchester: Research Explorer - Publications |
| Subject Terms: |
PsA; serum drug levels; therapeutic response; adalimumab; etanercept; TNF-i; pharmacokinetics |
| Description: |
Objectives. Up to 40% of psoriatic arthritis (PsA) patients experience first-line Tumour Necrosis Factor inhibitors (TNF-i) failure. Lower serum drug levels (SDL) have been associated with lower response in autoimmune conditions. This study aimed to: (i) establish the relationship between adalimumab (ADL) and etanercept (ETN) SDL and 3-month response; and (ii) identify optimal non-trough SDL thresholds in PsA. Methods. PsA patients commencing ADL or ETN were recruited to the UK observational study OUTPASS. Patients were seen pre-TNF-i and at 3 months when response was measured, and non-trough serum samples collected. Response was defined according to the PsARC or EULAR criteria. Descriptive statistics and concentration-effect curves established differences in SDL based on response. Receiver operating characteristics and regression identified optimal SDL thresholds. Results. PsA ETN (n=97) PsARC and EULAR good responders had significantly higher 3-month SDL compared to non-responders (p=0.006 and p=0.020 respectively). Non-trough 3-month ETN SDL discriminated PsARC responders from non-responders (AUC=0.70), with a threshold of 1.8µg/ml being 63% specific and 69% sensitive. EULAR good and non-/moderate responders were discriminated with an AUC of 0.65 with a threshold of 2.0µg/ml being 57% specific and 69% sensitive. ADL prescribed (n=104) EULAR good responders had significantly higher 3-month SDL (p=0.049). Non-trough 3-month ADL SDL discriminated EULAR good and non-/moderate responders (AUC=0.63) with a threshold of 3.6µg/ml being 48% specific and 81% sensitive. Conclusion. Higher 3-month SDL were detected in responders. Interventions to optimise SDL may improve treatment response earlier. This study suggests 3-month SDL thresholds which may be useful in clinical practice to optimise treatment response. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1462-0324; 1462-0332 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pissn/1462-0324; info:eu-repo/semantics/altIdentifier/eissn/1462-0332 |
| DOI: |
10.1093/rheumatology/kead666 |
| Availability: |
https://research.manchester.ac.uk/en/publications/20f0f1bd-dbbc-4f56-8d39-dc59cc542d4c; https://doi.org/10.1093/rheumatology/kead666 |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.B0E2200 |
| Database: |
BASE |