| Abstract [eng] |
Biological drugs (BD) have been used in the treatment of autoimmune arthritis (AA) for over 15 years. In spite of the many randomized clinical trials on BD, there is a lack of data on the special aspects of long-term application in everyday rheumatology clinical practice; for this reason the aim of our work was to evaluate the effectiveness, safety and immunogenicity of BD for the treatment of patients with AA. We found that treatment with different BD in AA patients is equally effective significant differences in efficacy of various infliximab dosages were not detected. Mild and moderate adverse events were most common during treatment with BD. Low agreement of tuberculin skin test and interferon-γ release assay for diagnosing latent tuberculosis (TB) before initiation of BD were found. During treatment with BD the highest active TB incidence was detected in patients treated with adalimumab, lowest – in patients with infliximab. During treatment with BD short – term work disability decreased significantly, although the number of patients with long – term work disability did not chang. In our study we analyzed immunogenicity of BD. Good correlation and agreement was found in measurement of tumor necrosis factor-α blockers concentration using immunoenzyme methods (sandwich and indirect) in patient’s sera. Good correlation, but not agreement was found in detecting anti-infliximab antibodies concentrations by immunoenzyme and radioimmunoassays. Detection of anti-infliximab antibodies was associated with loss of clinical effect, increased frequency of infusion reactions, as well as secondary inefficacy and change of treatment. Detection of anti-adalimumab antibodies was associated with loss of clinical effect. |
