The influence of tocilizumab immunogenicity markers on the effectiveness of treating rheumatoid arthritis

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Abstract

Purpose. The study assesses the impact of tocilizumab immunogenicity markers on clinical response to conducted treatment in patients with rheumatoid arthritis.

Materials and methods. A total of 17 patients with the confirmed diagnosis of RA receiving tocilizumab therapy for more than 1 year were enrolled into the study. Blood serum samples were collected once every six months before every drug injection during 2.5 years of treatment. The concentration of antibodies to tocilizumab and level of tocilizumab was determined using the ELISA. Additionally, DAS28 values were measured at the first and the last patient visit during the course of study, whereas levels of C-reactive protein (CRP), white blood cells, platelets, rheumatoid factor, and circulating immune complexes were only measured at the last examination.

Results. Positive correlations between the antibodies to tocilizumab and the last point DAS28 values were found, as well as a negative correlation of tocilizumab level and the level of DAS28.

Conclusions. The data obtained indicate a significant effect of serum levels of tocilizumab, as well as of the concentration of antibodies to tocilizumab on the effectiveness of RA treatment. A routine study of these biomarkers might be useful for individualizing treatment approaches for RA patients and determining the causes of tocilizumab resistance.

About the authors

Vladimir D. Nazarov

First Pavlov State Medical University of St. Petersburg

Author for correspondence.
Email: nazarov19932@mail.ru
ORCID iD: 0000-0002-9354-8790

Laboratory of autoimmune diseases, Scientific and Methodological Center for Molecular Medicine of the Ministry of Health Care of the Russian Federation

Russian Federation, L'va Tolstogo str. 6-8 Saint Petersburg, 197022

Sergey V. Lapin

First Pavlov State Medical University of St. Petersburg

Email: svlapin@mail.ru
ORCID iD: 0000-0002-4998-3699

Head of the Laboratory of autoimmune diseases, Scientific and Methodological Center for Molecular Medicine of the Ministry of Health Care of the Russian Federation

Russian Federation, L'va Tolstogo str. 6-8 Saint Petersburg, 197022

Ksenia V. Tulenko

FSBEI HE North-Western State Medical University named after I. I. Mechnikov

Email: bolt_kv@mail.ru
ORCID iD: 0000-0003-1805-8246

PhD-student of Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care named after E.E.Eichwald

Russian Federation, Saint-Petersburg, 191015, Kirochnaya st., 41

Rusana R. Samigullina

FSBEI HE North-Western State Medical University named after I. I. Mechnikov

Email: dr.samigullina@yandex.ru
ORCID iD: 0000-0002-6341-3334

assistant of  Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care named after E.E.Eichwald, MD

Russian Federation, Saint-Petersburg, 191015, Kirochnaya st., 41

Vadim I. Mazurov

FSBEI HE North-Western State Medical University named after I. I. Mechnikov

Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051

D. Sci. (Med.), Prof., RAS academician,  Head of the research institute of Rheumatology  North-Western State Medical University named after I.I. Mechnikov, head of Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care named after E.E.Eichwald FSBEI HE North-Western State Medical University named after I. I. Mechnikov

Russian Federation, Saint-Petersburg, 191015, Kirochnaya st., 41

References

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Supplementary files

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2. Fig. 1. Correlation between concentration of anti-tocilizumab antibodies with DAS28 (a) and number of leucocytes (b)

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3. Fig. 2. Correlation between tocilizumab level with concentration of C-reactive protein (a) and correlation of mean tocilizumab level with C-reactive protein (b) and DAS28 (c)

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Copyright (c) 2020 Nazarov V.D., Lapin S.V., Tulenko K.V., Samigullina R.R., Mazurov V.I.

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