|Tipo di tesi||Tesi di laurea magistrale|
|Titolo||Presenza di anticorpi anti Infliximab ed efficacia del farmaco: studio prospettico in campione di pazienti affetti da artriti infiammatorie|
|Titolo in inglese|
|Struttura||Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze|
|Corso di studi||MEDICINA E CHIRURGIA (D.M.270/04)|
|Data inizio appello||2016-03-10|
|Disponibilità||Accessibile via web (tutti i file della tesi sono accessibili)|
PREMESSA: Abbiamo testato un gruppo di 21 pazienti affetti da artriti infiammatorie (Artrite reumatoide, Spondilite anchilosante, Artrite Psoriasica) in trattamento come farmaco l’anticorpo monoclonale Infliximab (IFX). Successivamente ciascun paziente è stato visitato clinicamente e sottoposto ad esami ematochimici e clini metrici.
BACKGROUND: We tested a group of 21 patients affected by inflammatory arthritis (Rheumatoid Arthritis, Ankylosing Spondilitis and Psoriatic Arthritis) using the monoclonal antibody drug Infliximab (IFX), then each patient has been visited clinically and subjected to scale evaluation and blood test. Our purpose was to detect the presence (or absence) of Anti drug Antibody (ADA) against Infliximab on those patients who had a clinically detectable worsening of basic disease; moreover we tried to find evidence between these aspects and serum Infliximab levels. METHODS: 21 patients were visited initially to the Rheumatolgy Operative Unit of Modena Policlinico; then subjected to TNFα Blocker Kit at NOCSAE in Baggiovara (significant values criteria were ≥10 AU/ml ADA levels and ≤3, ≥7 μg/ml Infliximab level), then re-visited using DAS28 score (AR, AP) and BASDAI score (SPA) to detect a worsening of basic disease. RESULTS: In the sample of our study 4 out of 21 patients riacutized in the period between ADA detection and clinical measurements, and 8 out of 21 developed ADA against IFX. We obtained statistically significant findings that all the riacutized patients (n=4) were positive for increased levels of ADAs. Moreover, in the same patients were find elevated Anti Nucleus Antibodies (ANA), and often an out of range values of serum IFX. CONCLUSION: Analysing our data we found evidence that both serum ADA levels and serum IFX levels out of ranges were correlated to a worsening disease in arthritis carrying patients. These findings suggest that periodical testing both ADA and IFX levels in a sub-population of rheumatologic patients should be considered as a relevant exam to know how early switch pharmacological therapy with a different DMARDs or a biosimilar drug.