Infusion reactions during infliximab treatment are not associated with IgE anti-infliximab antibodies

Karin A. van Schie, Pleuni Ooijevaar-de Heer, Simone Kruithof, Chamaida Plasencia, Teresa Jurado, Dora Pascual Salcedo, Johannan F. Brandse, Geert Ram D'Haens, Gerrit Jan Wolbink, Theo Rispens

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12 Citations (Scopus)

Abstract

Controversy exists on the role of IgE antidrug antibodies (IgE-ADA) in infusion reactions (IR) on infliximab treatment, partly due to the lack of a positive control used for assay validation. We sought to (1) develop a robust assay to measure IgE-ADA, including a positive control, (2) determine the association between IgE-ADA and IR and (3) determine the incidence of IgE-ADA in infliximab treated patients. A recombinant human IgE anti-infliximab monoclonal antibody was developed as standard and positive control. With this antibody, we set up a novel robust assay to measure IgE-ADA. IgE-ADA was determined in three retrospective cohorts (n=159) containing IR+ (n=37) and IR- (n=39), and longitudinal sera of 83 spondyloarthritis. IgE-ADA was found in 0/39 IR-, whereas 4/37 (11%) IR+ showed low levels (0.1-0.3 IU/mL, below the 0.35 IU/mL threshold associated with elevated risk of allergic symptoms). All patients who were IgE-ADA positive also had (very) high IgG-ADA levels. The incidence of IgE-ADA in patients with infliximab-treated spondyloarthritis was estimated at less than approximately 1%. IgE-ADA is rarely detected in infliximab-treated patients. Moreover, the absence of IgE-ADA in the majority of IR+ patients suggests that IgE-ADA is not associated with infusion reactions
Original languageEnglish
Pages (from-to)1285-1288
JournalAnnals of the rheumatic diseases
Volume76
Issue number7
Early online date2017
DOIs
Publication statusPublished - 2017

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