生物制品可能会引发抗药物抗体(ADAs)的产生,其临床意义尚不完全清楚。用IL-17抑制剂治疗银屑病患者的ADA发展通过发病率进行评估,对疗效的影响,以及与不良事件的关系。我们系统地搜索了PubMed,科克伦,和Embase数据库,标识456个引用。17项研究符合纳入标准。ADA发生率为:0%至5.5%(苏金单抗),11%至19.4%(ixekizumab),0%至3.3%(Brodalumab),和19%至39%(bimekizumab)。中和抗体发生率为:0%至1.5%(苏金单抗),0%至3.5%(ixekizumab),和0%(Brodalumab)。ADA与苏金单抗单独存在,ixekizumab,和bimekizumab不影响药物疗效.Brodalumab是唯一的IL-17抑制剂,显示ADA+患者的疗效降低。在一项分析中,ixekizumab的高ADA滴度与治疗反应降低相关.苏金单抗和比马单抗的ADAs与不良事件无关。关于ixekizumab或brodalumab的ADAs和安全性的数据有限。总的来说,在使用苏金单抗监测患者时,ADAs,滴度,中和抗体的存在并不是预后的结果.然而,使用brodalumab监测ADAs和使用ixekizumab测量滴度可能具有临床价值.
Biologics may elicit the production of anti-drug antibodies (ADAs), the clinical significance of which is not fully understood. ADA development in psoriasis patients on IL-17 inhibitors was evaluated by incidence, impact on efficacy, and relationship with adverse events. We systematically searched PubMed, Cochrane, and Embase databases, identifying 456 references. Seventeen studies met inclusion criteria. ADA incidence was: 0% to 5.5% (secukinumab), 11% to 19.4% (ixekizumab), 0% to 3.3% (brodalumab), and 19% to 39% (bimekizumab). Neutralizing antibody incidence was: 0% to 1.5% (secukinumab), 0% to 3.5% (ixekizumab), and 0% (brodalumab). ADA presence alone with secukinumab, ixekizumab, and bimekizumab did not impact drug efficacy. Brodalumab was the only one of the IL-17 inhibitors, which showed a reduction in efficacy in ADA + patients. In one analysis, high ADA titers to ixekizumab were associated with diminished treatment response. ADAs to secukinumab and bimekizumab were not associated with adverse events. There were limited data on ADAs and safety with ixekizumab or brodalumab. Overall, when monitoring patients on secukinumab, ADAs, titers, and the presence of neutralizing antibodies were not prognostic of outcomes. However, monitoring for ADAs with brodalumab and measuring titers with ixekizumab may be of value clinically.