1. HLA-DQA1*05 Carriage Associated With Development of Anti-Drug Antibodies to Infliximab and Adalimumab in Patients With Crohn's Disease
- Author
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Timothy R. Orchard, Rosemary H Phillips, Stephen M. Evans, Arvind Ramadas, Paul R. Banim, Guy Chung-Faye, Subramaniam Ramakrishnan, Simon Panter, Leonie Grellier, Hasnain Jafferbhoy, Nigel Trudgill, Thankam Paul, Sian Kirkham, Anna J Pigott, M J Carter, Juan De La Revella Negro, Lisa Gervais, Zia Mazhar, Suranga Dharmisari, Richard A. Miller, Cathryn Preston, Alison Simmons, Rachel Cooney, Natalie C. Direkze, Deb Ghosh, Christian P. Selinger, Andrew A. Fagbemi, Rakesh Chaudhary, J R Fraser Cummings, Stephen Gore, James O. Lindsay, Tony C.K. Tham, David Hobday, Charles Murray, David Watts, Anne Willmott, Gill Watts, Sandip Sen, Mark Reppell, Amer Azaz, Shaji Sebastian, Neil Chanchlani, R B Johnston, Ben Hope, Salil Singh, Stephen Foley, Sunil Sonwalkar, Jonathon Snook, Lawrence Armstrong, Amanda Beale, Andy Li, Tariq Mahmood, Stephen Lewis, Kevin J. Monahan, Timothy J. McDonald, Gareth T. Jones, John N. Gordon, Nicholas A Kennedy, Sheldon C. Cooper, Gareth J. Walker, James W Hart, Sarah Langlands, Carl A. Anderson, Marcus Harbord, Alistair McNair, Achuth Shenoy, Graham A. Heap, Radhakrishnan Hariraj, Mandy H Perry, Charlie Lees, Shanika de Silva, Christopher J. Hawkey, Loukas Moutsianas, Matthew J Brookes, Christos Tzivinikos, Veena Zamvar, Cathryn Edwards, Claire Bell, Rebecca Saich, Peter M. Irving, Mark S. Smith, Phillip Mayhead, Christopher Macdonald, Dharamveer Basude, Andrew T. Cole, Ailsa Hart, Daniel R. Gaya, Kasamu Dawa Kabiru, Assad Butt, John C Mansfield, John Beckly, Anton V J Gunasekera, Simon Lal, Charles Pj Charlton, Astor Rodrigues, Craig Mowat, Joel Mawdsley, Palani Sathish Babu, John C. Mansfield, Mary-Anne Morris, Senthil V. Murugesan, Dermot P.B. McGovern, Richard Pollok, Franco Torrente, Jeffrey C. Barrett, Aleksejs Sazonovs, Aminda De Silva, George MacFaul, Paul Dunckley, Neeraj Prasad, Zahid Mahmood, Neil P. Shah, Richard Shenderey, Tariq Iqbal, Anjan Dhar, Bruce McLain, James R Goodhand, Anita Modi, Daniel L. Rice, Patrick Goggin, Alka Thakur, Vinod B. Patel, Vishal Kaushik, Scott Levison, Sonia Bouri, Fraser Cummings, Emma Wesley, Anurag Agrawal, Deven Vani, Jimmy K. Limdi, Miles Parkes, David A Elphick, Mark Tighe, Nicholas M. Croft, Charlie W. Lees, Helen Matthews, B K Baburajan, Andrew Bell, Melissa A. Smith, Tariq Ahmad, Stephen Bridger, Mark Tremelling, Matthew W. Johnson, John Fell, Claire Bewshea, Bim Bhaduri, Julie Doherty, Sean Weaver, Ben Colleypriest, Chuka U. Nwokolo, John de Caestecker, Richard K. Russell, Stuart Bloom, Rice, Daniel L [0000-0002-2972-0365], Chanchlani, Neil [0000-0003-0207-6706], McDonald, Timothy J [0000-0003-3559-6660], Anderson, Carl A [0000-0003-1719-7009], and Apollo - University of Cambridge Repository
- Subjects
0301 basic medicine ,Male ,Inflammatory bowel disease ,Gastroenterology ,Infliximab/immunology ,0302 clinical medicine ,Crohn Disease ,GWAS ,Crohn's disease ,Immunogenicity ,Hazard ratio ,PANTS ,Crohn Disease/blood ,Middle Aged ,Ulcerative colitis ,Loss Of Response ,030211 gastroenterology & hepatology ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Heterozygote ,Combination therapy ,Drug Persistence ,HLA-DQ alpha-Chains ,03 medical and health sciences ,Young Adult ,Adalimumab/immunology ,Internal medicine ,HLA-DQ alpha-Chains/genetics ,medicine ,Adalimumab ,Humans ,Alleles ,Gastroenterology & Hepatology ,Hepatology ,Tumor Necrosis Factor-alpha ,business.industry ,Tumor Necrosis Factor-alpha/antagonists & inhibitors ,Patient Selection ,1103 Clinical Sciences ,medicine.disease ,Infliximab ,030104 developmental biology ,1114 Paediatrics and Reproductive Medicine ,1109 Neurosciences ,business ,Genome-Wide Association Study - Abstract
BACKGROUND & AIMS: Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.METHODS: We performed a genome-wide association study to identify variants associated with time to development of anti-drug antibodies in a discovery cohort of 1240 biologic-naïve patients with Crohn's disease starting infliximab or adalimumab therapy. Immunogenicity was defined as an anti-drug antibody titer ≥10 AU/mL using a drug-tolerant enzyme-linked immunosorbent assay. Significant association signals were confirmed in a replication cohort of 178 patients with inflammatory bowel disease.RESULTS: The HLA-DQA1*05 allele, carried by approximately 40% of Europeans, significantly increased the rate of immunogenicity (hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.60-2.25; P = 5.88 × 10-13). The highest rates of immunogenicity, 92% at 1 year, were observed in patients treated with infliximab monotherapy who carried HLA-DQA1*05; conversely the lowest rates of immunogenicity, 10% at 1 year, were observed in patients treated with adalimumab combination therapy who did not carry HLA-DQA1*05. We confirmed this finding in the replication cohort (HR, 2.00; 95% CI, 1.35-2.98; P = 6.60 × 10-4). This association was consistent for patients treated with adalimumab (HR, 1.89; 95% CI, 1.32-2.70) or infliximab (HR, 1.92; 95% CI, 1.57-2.33), and for patients treated with anti-TNF therapy alone (HR, 1.75; 95% CI, 1.37-2.22) or in combination with an immunomodulator (HR, 2.01; 95% CI, 1.57-2.58).CONCLUSIONS: In an observational study, we found a genome-wide significant association between HLA-DQA1*05 and the development of antibodies against anti-TNF agents. A randomized controlled biomarker trial is required to determine whether pretreatment testing for HLA-DQA1*05 improves patient outcomes by helping physicians select anti-TNF and combination therapies. ClinicalTrials.gov ID: NCT03088449.
- Published
- 2020
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