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Turkish Journal of Medical Sciences

Author ORCID Identifier

ALPER DOĞANCI: 0000-0003-1216-2667

ŞEBNEM ATAMAN: 0000-0003-3570-3825

ALİ ÖZDEMİREL: 0000-0001-9174-1792

RECEP SEÇKİN: 0000-0002-4187-9299

AYŞE YALÇIN: 0000-0003-0426-1200

SEVİM BAVBEK: 0000-0002-7884-0830

DOI

10.55730/1300-0144.5914

Abstract

Background and aim: We aimed to investigate the relationship between serum anti-drug antibody (ADAb), hypersensitivity reactions (HSRs) to anti-tumor necrosis factors (anti-TNFs) drugs and to detect the role of skin tests in the diagnosis of HSRs against anti-TNFs.Material and methods: 69 ankylosing spondilitis (AS) and 46 rheumatoid artritis (RA) patients using infliximab, adalimumab, and etanercept were enrolled. Disease activity scores for AS and RA patients were assessed. Serum levels of anti-TNFs and ADAb to these agents were measured with the ELISA.These blood samples were taken 24 hours before the next drug dose.The patients with anti-TNF-associated HSRs were evaluated with a skin prick test (SPT) and intradermal test (IDT). Readings for SPT and IDT were conducted after 15 min, 24, 48, and 72 hours. Heel diameter of 3 mm or more, greater than negative control was considered positive for SPT, and if the size of the initial wheal had increased by at least 3 mm in diameter and was surrounded by erythema was considered positive for IDT. Symptoms such as urticaria/angioedema, flushing, etc. were considered immediate type HSRs. Findings developed at the injection site such as swelling, erythema, etc were considered injection site reactions (ISRs). An overall p<0.05 was considered statistically significant.Results: A statistically significant association was found between HSRs (immediate type and ISRs) and IDTs reported by patients using biological drugs (p=0.001). In the subgroup analysis, a statistically significant association was found between ISRs and IDTs in users of ADA and ETN (respectively p=0.012, p=0.013). No relationship was found between skin test positivity (IDT) and the presence of IgG ADAb to Anti-TNFs, and disease activity scores. Conclusion: This study demonstrates that patients who exhibit ISRs to anti-TNF drugs produce notably positive results to IDT without maintaining a direct relationship to serum levels of ADAb.

Keywords

Hypersensitivity reactions, immunogenicity, intradermal test, serum antidrug antibodies, skin prick test

First Page

1310

Last Page

1318

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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