{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T08:00:07Z","timestamp":1773734407186,"version":"3.50.1"},"reference-count":0,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T00:00:00Z","timestamp":1593475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> TNF-&amp;alpha; blocker therapy is part of the treatment with biologics used in the management of inflammatory joint diseases. In recent years, drug-induced neutralizing antibodies have been shown to have a negative effect on the course of the disease process.<\/jats:p>\n          <jats:p><jats:bold>Aim:<\/jats:bold> To investigate drug-induced neutralizing antibodies against TNF-&amp;alpha; blocking drugs used in patients with inflammatory joint diseases and their effect on the clinical course of the disease.<\/jats:p>\n          <jats:p><jats:bold>Materials and methods:<\/jats:bold> The study included 121 (56.8%) patients with rheumatoid arthritis, 50 (23.5%) patients with ankylosing spondylitis, 42 (19.7%) patients with psoriatic arthritis, and 31 sex and age-matched healthy controls. The patients were monitored at 0, 6, 12, and 24 months after initiation of TNF-&amp;alpha; blocker treatment. The demographic data, vital signs and the parameters of inflammatory activity (C-reactive protein, erythrocyte sedimentation rate, and disease activity indices) were analyzed in all patients. Drug-induced anti-TNF-&amp;alpha; blockers antibodies (adalimumab and etanercept) were analyzed using ELISA. Statistical analysis was performed with SPSS v. 24.<\/jats:p>\n          <jats:p><jats:bold>Results:<\/jats:bold> Drug-induced neutralizing antibodies against adalimumab were obtained in 11.57% of patients at 6 month, in 17.64% at 12 month, and in 24.8% at 24 month. Drug-induced neutralizing antibodies to etanercept were not demonstrated in patients followed up at 6 months, at 7.77% at 12 months, and at 9.63% at 24 months. Between the presence of neutralizing antibodies to blockers of TNF-&amp;alpha; and indices available for disease activity, there is a strong positive correlation and Pearson Correlation = 0.701, <jats:italic>p<\/jats:italic>=0.001. Patients with poor clinical response and available antibodies against adalimumab at 12 months were 82.36% and patients treated with etanercept 71.42%. The difference between the two groups was non-significant (<jats:italic>U<\/jats:italic> = 0.527, <jats:italic>p<\/jats:italic>&gt; 0.05). Patients with poor clinical response and available anti-adalimumab antibodies at 24 month were 75%, and in patients treated with etanercept &amp;ndash; 87.50%, the difference between the two groups not being able to reach significance (<jats:italic>U<\/jats:italic> = 0.623, <jats:italic>p<\/jats:italic>&gt; 0.05).<jats:bold> <\/jats:bold><\/jats:p>\n          <jats:p><jats:bold>Conclusion:<\/jats:bold><jats:bold> <\/jats:bold>Drug-induced neutralizing antibodies against TNF-&amp;alpha; blockers (adalimumab and etanercept) have a negative effect on the course of inflammatory joint disease and can be used as reliable biomarker to assess the effect of the treatment with these drugs.<\/jats:p>","DOI":"10.3897\/folmed.62.e39402","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T18:18:40Z","timestamp":1593541120000},"page":"282-289","source":"Crossref","is-referenced-by-count":8,"title":["Drug-neutralizing Antibodies against&amp;nbsp;TNF-&amp;alpha; blockers as Biomarkers of Therapy Effect Evaluation"],"prefix":"10.3897","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-117X","authenticated-orcid":true,"given":"Krasimir","family":"Kraev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariela","family":"Geneva-Popova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Velichka","family":"Popova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanislava","family":"Popova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Maneva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-0574","authenticated-orcid":true,"given":"Anastas","family":"Batalov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodora","family":"Stankova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ginka","family":"Delcheva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katya","family":"Stefanova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2020,6,30]]},"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/39402\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/39402\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=39402&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T18:18:40Z","timestamp":1593541120000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/39402\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,6,30]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.62.e39402","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2020,6,30]]}}}