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Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results.


ABSTRACT: Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFN?) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, considering the number of ADA tests performed and type of ADA assays used, and to determine the frequency of ADA testing against the different drug preparations in different countries. A common database platform (tranSMART) for querying, analyzing and storing retrospective data of MS cohorts was set up to harmonize the data and compare results of ADA tests between different countries. Retrospective data from six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFN? preparations was confirmed in this large dataset. Decreased usage of the more immunogenic preparations IFN?-1a subcutaneous (s.c.) and IFN?-1b s.c. in favor of the least immunogenic preparation IFN?-1a intramuscular (i.m.) was observed. The median time from treatment start to first ADA test correlated with time to first positive test. Shorter times were observed for IFN?-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFN?-1a i.m. (1.41 and 2.27 years), IFN?-1b-Betaferon s.c. (2.51 and 1.96 years) and IFN?-1a s.c. (2.11 and 2.09 years) which were available years before routine testing began. A higher rate of anti-IFN? ADA was observed in test samples taken from older patients. Testing for ADA varies between different European countries and is highly dependent on the policy within each country. For drugs where routine monitoring of ADA is not in place, there is a risk that some patients remain on treatment for several years despite ADA positivity. For drugs where a strategy of ADA testing is introduced with the release of the drug, there is a reduced risk of having ADA positive patients and thus of less efficient treatment. This indicates that potential savings in health cost might be achieved by routine analysis of ADA.

SUBMITTER: Link J 

PROVIDER: S-EPMC5295710 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe: A descriptive study of test results.

Link Jenny J   Ramanujam Ryan R   Auer Michael M   Ryner Malin M   Hässler Signe S   Bachelet Delphine D   Mbogning Cyprien C   Warnke Clemens C   Buck Dorothea D   Hyldgaard Jensen Poul Erik PE   Sievers Claudia C   Ingenhoven Kathleen K   Fissolo Nicolas N   Lindberg Raija R   Grummel Verena V   Donnellan Naoimh N   Comabella Manuel M   Montalban Xavier X   Kieseier Bernd B   Soelberg Sørensen Per P   Hartung Hans-Peter HP   Derfuss Tobias T   Lawton Andy A   Sikkema Dan D   Pallardy Marc M   Hemmer Bernhard B   Deisenhammer Florian F   Broët Philippe P   Dönnes Pierre P   Davidson Julie J   Fogdell-Hahn Anna A  

PloS one 20170207 2


Antibodies against biopharmaceuticals (anti-drug antibodies, ADA) have been a well-integrated part of the clinical care of multiple sclerosis (MS) in several European countries. ADA data generated in Europe during the more than 10 years of ADA monitoring in MS patients treated with interferon beta (IFNβ) and natalizumab have been pooled and characterized through collaboration within a European consortium. The aim of this study was to report on the clinical practice of ADA testing in Europe, cons  ...[more]

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