Neutralising antibodies againts TNF blockers

Indication

As an aid in monitoring treatment efficacy, drug concentrations can be established and hereby help optimizing individual patient treatment strategy. Moreover, monitoring the effect of the drug can determine if the patient develops neutralizing anti-drug antibodies (NAbs) that target the drug.

The following drugs can currently be tested at Wieslab

The list is updated regularly so please check back for the latest available tests. 

  • Remicade (Infliximab): Activity of drug and analysis for NAbs.
  • Humira (Adalimumab): Activity of drug and analysis for NAbs.
  • Enbrel (Etanercept): Activity of drug and analysis for NAbs.
  • Simponi (Golimumab): Activity of drug and analysis for NAbs.
  • Cimzia (Certolizumab pegol) Only activity of drug. Analysis for NAbs is under development.

Test result

Test results for NAbs to TNF blockers are reported as negative or positive with titer.

Testing for NAbs against TNF blockers are performed only when the concentration of TNF blockers activity in serum is < 0.65 ¬Ķg/mL.

Method

The assay for TNF blocker NAbs is based on the same in vitro reporter cell line (iLite) which is used to measure the activity (concentration) of the drug (Lallemand 2011). In short, the NAbs tests show if antibodies in patient serum can prevent TNF-inhibitor activity in an in vitro cell model.

Result interpretation

NAbs are defined as antibodies that prevent TNF-inhibitor binding and thus makes the treatment ineffective.

  • A reduced efficacy of treatment with TNF blockers depends in many cases on NAbs against the drug. In case of positive results for NAbs and a secondary treatment failure, it is highly recommended to change the drug as it influences the efficacy of the particular TNF blocker.
  • When it is uncertain if the NAbs cause treatment failure, the patient should be followed up with regular monitoring, since there is a high risk that NAbs sooner or later will affect the efficacy of the TNF blocker.
  • NAbs do not cross-react between the different TNF blockers.

Read more on the following pages:

Packages and other tests

. View other tests Concentration of TNF blockers

Acute test