Initial laboratory experience from the first UK centre offering anti-TNF-α drug and anti-drug antibody monitoring to aid personalised therapy

Abstract

Introduction: NICE guidance recommends the use of biologic drugs for the treatment of inflammatory disease in Rheumatology, Dermatology and Gastroenterology with restrictions. Infliximab (Remicade®) is a chimeric monoclonal antibody which binds to and blocks the action of TNFalpha. Though highly effective, a significant proportion of patients don´t respond or lose response. One proposed mechanism is the formation of anti-drug antibodies (ADAb) which may neutralise biological activity and/or increase clearance leading to sub-therapeutic drug levels.

Aim: The literature suggests that the measurement of drug and ADAb is a cost-effective tool in clinical decision-making. Here we report our experience as the first UK centre offering such a service.