Attn Re: RESEARCH - Remicade, but not Enbrel, etc

[Guest guest]

- what does this mean in English- I have no clue. I dont mean to sound

dumb- but it is way over my head.

JIll

[Guest guest]

Hi, Jill.

These researchers studied 34 patients with spondyloarthropathy (SpA) and 59

people with rheumatoid arthritis (RA) who took Remicade (infliximab) for two

years. They also followed 20 patients with SpA who took Enbrel (etanercept)

for one year.

Spondyloarthropathies are diseases in which autoimmune antibodies are not

normally found (or if they are, the titers are low). Psoriatic arthritis

(PA) would be one example of a spondyloarthropathy and ankylosing

spondylitis (AS) is another. See this site for more info on

spondyloarthropathies:

eMedicine.com

" Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy " :

http://www.emedicine.com/med/topic2700.htm

They found that both the SpA and RA patients on Remicade formed ANA,

anti-dsDNA, and aCL antibodies that they didn't have before treatment (these

are antibodies usually closely associated with lupus, especially

anti-dsDNA); however, the class of antibodies that formed was primarily IgM

(immunoglobulin M), which isn't as troublesome (in terms of autoimmunity) as

IgG.

Only about 10% of the people with SpA who were on Enbrel for a year produced

such antibodies.

The antibodies were no longer present in the patients' sera after

discontinuation of Remicade or Enbrel.

More on humoral immunity here:

Dr. E. Kaiser

" The Adaptive Immune System: Antibodies - 5 Classes of Human Antibodies " :

http://www.cat.cc.md.us/courses/bio141/lecguide/unit3/humoral/antibodies/5classe\

s/5classes.html

The authors conclude that this type of immune response is not that serious

and it is more of an issue with Remicade than with Enbrel. If it were a

" class effect, " then you would see the same sort of results with Remicade,

Enbrel, and Humira. Since the results were different for Remicade and

Enbrel, they claim it is not a class effect.

Also noted was that despite the presence of these antibodies, no clinical

(symptoms) or other serologic (blood) signs of lupus developed. So, it's not

really lupus.

I wish they would have included RA patients on Enbrel for a year, but that's

just me.

I don't have access to the full-text version of this article, so that's

about as much as I can tell you about it.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Arthritis Rheum. 2005 Jul;52(7):2192-201.

Infliximab, but not etanercept, induces IgM anti-double-stranded DNA

autoantibodies as main antinuclear reactivity: biologic and clinical

implications in autoimmune arthritis.

De Rycke L, Baeten D, Kruithof E, Van den Bosch F, Veys EM, De Keyser F.

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.

Leen.DeRycke@...

OBJECTIVE: To analyze the clinical and biologic correlates of autoantibody

induction during longer-term tumor necrosis factor alpha (TNFalpha) blockade

with either the monoclonal antibody infliximab or the soluble receptor

etanercept. METHODS: Thirty-four patients with spondylarthropathy (SpA) and

59 patients with rheumatoid arthritis (RA) were treated with infliximab for

2 years. Additionally, 20 patients with SpA were treated with etanercept for

1 year. Sera were blindly analyzed for antinuclear antibodies (ANAs),

anti-double-stranded DNA (anti-dsDNA) antibodies, anti-extractable nuclear

antigen (anti-ENA) antibodies, and antihistone, anti-nucleosome, and

anticardiolipin antibodies (aCL). The anti-dsDNA antibodies were isotyped.

RESULTS: High numbers of infliximab-treated patients with SpA or RA had

newly induced ANAs (61.8% and 40.7%, respectively) and anti-dsDNA antibodies

(70.6% and 49.2%, respectively) after 1 year, but no further increase

between year 1 and year 2 was observed. In contrast, induction of ANAs and

anti-dsDNA antibodies was observed only occasionally in the

etanercept-treated patients with SpA (10% of patients each). Isotyping

revealed almost exclusively IgM or IgM/IgA anti-dsDNA antibodies, which

disappeared upon interruption of treatment. Neither infliximab nor

etanercept induced other lupus-related reactivities such as anti-ENA

antibodies, antihistone antibodies, or anti-nucleosome antibodies, and no

clinically relevant lupus-like symptoms were observed. Similarly, infliximab

but not etanercept selectively increased IgM but not IgG aCL titers.

CONCLUSION: The prominent ANA and anti-dsDNA autoantibody response is not a

pure class effect of TNFalpha blockers, is largely restricted to short-term

IgM responses, and is not associated with other serologic or clinical signs

of lupus. Similar findings with aCL suggest that modulation of humoral

immunity may be a more general feature of infliximab treatment.

PMID: 15986349

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5986349 & dopt=Citation

[ ] Attn Re: RESEARCH - Remicade, but not Enbrel, etc

> - what does this mean in English- I have no clue. I dont mean to sound

> dumb- but it is way over my head.

> JIll

[Guest guest]

Thank you very much from me, too!! Geri

<Matsumura_Clan@...> wrote:Hi, Jill.

These researchers studied 34 patients with spondyloarthropathy (SpA) and 59

people with rheumatoid arthritis (RA) who took Remicade (infliximab) for two

years. They also followed 20 patients with SpA who took Enbrel (etanercept)

for one year.

Spondyloarthropathies are diseases in which autoimmune antibodies are not

normally found (or if they are, the titers are low). Psoriatic arthritis

(PA) would be one example of a spondyloarthropathy and ankylosing

spondylitis (AS) is another. See this site for more info on

spondyloarthropathies:

eMedicine.com

" Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy " :

http://www.emedicine.com/med/topic2700.htm

They found that both the SpA and RA patients on Remicade formed ANA,

anti-dsDNA, and aCL antibodies that they didn't have before treatment (these

are antibodies usually closely associated with lupus, especially

anti-dsDNA); however, the class of antibodies that formed was primarily IgM

(immunoglobulin M), which isn't as troublesome (in terms of autoimmunity) as

IgG.

Only about 10% of the people with SpA who were on Enbrel for a year produced

such antibodies.

The antibodies were no longer present in the patients' sera after

discontinuation of Remicade or Enbrel.

More on humoral immunity here:

Dr. E. Kaiser

" The Adaptive Immune System: Antibodies - 5 Classes of Human Antibodies " :

http://www.cat.cc.md.us/courses/bio141/lecguide/unit3/humoral/antibodies/5classe\

s/5classes.html

The authors conclude that this type of immune response is not that serious

and it is more of an issue with Remicade than with Enbrel. If it were a

" class effect, " then you would see the same sort of results with Remicade,

Enbrel, and Humira. Since the results were different for Remicade and

Enbrel, they claim it is not a class effect.

Also noted was that despite the presence of these antibodies, no clinical

(symptoms) or other serologic (blood) signs of lupus developed. So, it's not

really lupus.

I wish they would have included RA patients on Enbrel for a year, but that's

just me.

I don't have access to the full-text version of this article, so that's

about as much as I can tell you about it.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Arthritis Rheum. 2005 Jul;52(7):2192-201.

Infliximab, but not etanercept, induces IgM anti-double-stranded DNA

autoantibodies as main antinuclear reactivity: biologic and clinical

implications in autoimmune arthritis.

De Rycke L, Baeten D, Kruithof E, Van den Bosch F, Veys EM, De Keyser F.

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.

Leen.DeRycke@...

OBJECTIVE: To analyze the clinical and biologic correlates of autoantibody

induction during longer-term tumor necrosis factor alpha (TNFalpha) blockade

with either the monoclonal antibody infliximab or the soluble receptor

etanercept. METHODS: Thirty-four patients with spondylarthropathy (SpA) and

59 patients with rheumatoid arthritis (RA) were treated with infliximab for

2 years. Additionally, 20 patients with SpA were treated with etanercept for

1 year. Sera were blindly analyzed for antinuclear antibodies (ANAs),

anti-double-stranded DNA (anti-dsDNA) antibodies, anti-extractable nuclear

antigen (anti-ENA) antibodies, and antihistone, anti-nucleosome, and

anticardiolipin antibodies (aCL). The anti-dsDNA antibodies were isotyped.

RESULTS: High numbers of infliximab-treated patients with SpA or RA had

newly induced ANAs (61.8% and 40.7%, respectively) and anti-dsDNA antibodies

(70.6% and 49.2%, respectively) after 1 year, but no further increase

between year 1 and year 2 was observed. In contrast, induction of ANAs and

anti-dsDNA antibodies was observed only occasionally in the

etanercept-treated patients with SpA (10% of patients each). Isotyping

revealed almost exclusively IgM or IgM/IgA anti-dsDNA antibodies, which

disappeared upon interruption of treatment. Neither infliximab nor

etanercept induced other lupus-related reactivities such as anti-ENA

antibodies, antihistone antibodies, or anti-nucleosome antibodies, and no

clinically relevant lupus-like symptoms were observed. Similarly, infliximab

but not etanercept selectively increased IgM but not IgG aCL titers.

CONCLUSION: The prominent ANA and anti-dsDNA autoantibody response is not a

pure class effect of TNFalpha blockers, is largely restricted to short-term

IgM responses, and is not associated with other serologic or clinical signs

of lupus. Similar findings with aCL suggest that modulation of humoral

immunity may be a more general feature of infliximab treatment.

PMID: 15986349

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5986349 & dopt=Citation

[ ] Attn Re: RESEARCH - Remicade, but not Enbrel, etc

> - what does this mean in English- I have no clue. I dont mean to sound

> dumb- but it is way over my head.

> JIll

[Guest guest]

Thank you very much from me, too!! Geri

<Matsumura_Clan@...> wrote:Hi, Jill.

These researchers studied 34 patients with spondyloarthropathy (SpA) and 59

people with rheumatoid arthritis (RA) who took Remicade (infliximab) for two

years. They also followed 20 patients with SpA who took Enbrel (etanercept)

for one year.

Spondyloarthropathies are diseases in which autoimmune antibodies are not

normally found (or if they are, the titers are low). Psoriatic arthritis

(PA) would be one example of a spondyloarthropathy and ankylosing

spondylitis (AS) is another. See this site for more info on

spondyloarthropathies:

eMedicine.com

" Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy " :

http://www.emedicine.com/med/topic2700.htm

They found that both the SpA and RA patients on Remicade formed ANA,

anti-dsDNA, and aCL antibodies that they didn't have before treatment (these

are antibodies usually closely associated with lupus, especially

anti-dsDNA); however, the class of antibodies that formed was primarily IgM

(immunoglobulin M), which isn't as troublesome (in terms of autoimmunity) as

IgG.

Only about 10% of the people with SpA who were on Enbrel for a year produced

such antibodies.

The antibodies were no longer present in the patients' sera after

discontinuation of Remicade or Enbrel.

More on humoral immunity here:

Dr. E. Kaiser

" The Adaptive Immune System: Antibodies - 5 Classes of Human Antibodies " :

http://www.cat.cc.md.us/courses/bio141/lecguide/unit3/humoral/antibodies/5classe\

s/5classes.html

The authors conclude that this type of immune response is not that serious

and it is more of an issue with Remicade than with Enbrel. If it were a

" class effect, " then you would see the same sort of results with Remicade,

Enbrel, and Humira. Since the results were different for Remicade and

Enbrel, they claim it is not a class effect.

Also noted was that despite the presence of these antibodies, no clinical

(symptoms) or other serologic (blood) signs of lupus developed. So, it's not

really lupus.

I wish they would have included RA patients on Enbrel for a year, but that's

just me.

I don't have access to the full-text version of this article, so that's

about as much as I can tell you about it.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Arthritis Rheum. 2005 Jul;52(7):2192-201.

Infliximab, but not etanercept, induces IgM anti-double-stranded DNA

autoantibodies as main antinuclear reactivity: biologic and clinical

implications in autoimmune arthritis.

De Rycke L, Baeten D, Kruithof E, Van den Bosch F, Veys EM, De Keyser F.

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.

Leen.DeRycke@...

OBJECTIVE: To analyze the clinical and biologic correlates of autoantibody

induction during longer-term tumor necrosis factor alpha (TNFalpha) blockade

with either the monoclonal antibody infliximab or the soluble receptor

etanercept. METHODS: Thirty-four patients with spondylarthropathy (SpA) and

59 patients with rheumatoid arthritis (RA) were treated with infliximab for

2 years. Additionally, 20 patients with SpA were treated with etanercept for

1 year. Sera were blindly analyzed for antinuclear antibodies (ANAs),

anti-double-stranded DNA (anti-dsDNA) antibodies, anti-extractable nuclear

antigen (anti-ENA) antibodies, and antihistone, anti-nucleosome, and

anticardiolipin antibodies (aCL). The anti-dsDNA antibodies were isotyped.

RESULTS: High numbers of infliximab-treated patients with SpA or RA had

newly induced ANAs (61.8% and 40.7%, respectively) and anti-dsDNA antibodies

(70.6% and 49.2%, respectively) after 1 year, but no further increase

between year 1 and year 2 was observed. In contrast, induction of ANAs and

anti-dsDNA antibodies was observed only occasionally in the

etanercept-treated patients with SpA (10% of patients each). Isotyping

revealed almost exclusively IgM or IgM/IgA anti-dsDNA antibodies, which

disappeared upon interruption of treatment. Neither infliximab nor

etanercept induced other lupus-related reactivities such as anti-ENA

antibodies, antihistone antibodies, or anti-nucleosome antibodies, and no

clinically relevant lupus-like symptoms were observed. Similarly, infliximab

but not etanercept selectively increased IgM but not IgG aCL titers.

CONCLUSION: The prominent ANA and anti-dsDNA autoantibody response is not a

pure class effect of TNFalpha blockers, is largely restricted to short-term

IgM responses, and is not associated with other serologic or clinical signs

of lupus. Similar findings with aCL suggest that modulation of humoral

immunity may be a more general feature of infliximab treatment.

PMID: 15986349

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5986349 & dopt=Citation

[ ] Attn Re: RESEARCH - Remicade, but not Enbrel, etc

> - what does this mean in English- I have no clue. I dont mean to sound

> dumb- but it is way over my head.

> JIll

[Guest guest]

Oh Ok- now that I can understand. Thanks so much for breaking it all down.

So much of what you post goes way over my head and I didnt want to post that

I was an idiot but I got tired of missing it all. I really appreciate it.

I do want to say that I appreciate you posting all the research articles. I

dont know if we say it enough- But I know that I do. Even if I dont always

read thru them all- But thank you!

Jill

On 8/25/05, <Matsumura_Clan@...> wrote:

>

> Hi, Jill.

>

> These researchers studied 34 patients with spondyloarthropathy (SpA) and

> 59

> people with rheumatoid arthritis (RA) who took Remicade (infliximab) for

> two

> years. They also followed 20 patients with SpA who took Enbrel

> (etanercept)

> for one year.

>

[Guest guest]

Say, Jill, you're very welcome. Thanks for your kind words.

You aren't an idiot. The research articles are sometimes very difficult to

read. It gets easier after you read a lot of them.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] Attn Re: RESEARCH - Remicade, but not Enbrel,

etc

> Oh Ok- now that I can understand. Thanks so much for breaking it all down.

> So much of what you post goes way over my head and I didnt want to post

> that

> I was an idiot but I got tired of missing it all. I really appreciate it.

> I do want to say that I appreciate you posting all the research articles.

> I

> dont know if we say it enough- But I know that I do. Even if I dont always

> read thru them all- But thank you!

> Jill

[Guest guest]

You are most welcome, Geri!

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] Attn Re: RESEARCH - Remicade, but not Enbrel,

etc

Thank you very much from me, too!! Geri