Related Experiment Video
Updated: Sep 17, 2025

Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Prevalence and Impact of Antibodies Against TNF Alpha Inhibitors in Rheumatoid Arthritis and Spondyloarthritis:
Ines Mahmoud1,2, Selma Bouden1,2, Rim Charfi3,2
1Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia.
Introduction:
We aimed to estimate the global prevalence of anti-drug antibodies (ADAb), their impact on treatment response, and associated factors in adults with rheumatoid arthritis (RA) and spondyloarthritis (SpA) treated with TNF alpha inhibitors (TNF-i).
Methods:
We searched PubMed, MEDLINE, Cochrane, Web of Science, and Scopus for observational population-based studies published between January 2010 and September 2021. We included studies reporting ADAb prevalence and their impact on treatment efficacy in adults treated with TNF-i.
Results:
The global prevalence of ADAb was 20.8% (95% CI: 6.8-25.5; 95% PI: 6.12-51.42) in RA and 24.8% (95% CI: 19.1-31.5; 95% PI: 7.31-57.98) in SpA. No significant difference in ADAb prevalence was found between infliximab (IFX) and adalimumab (ADA) in RA (p = 0.21) or SpA (p= 0.46). Significant differences were found between IFX and etanercept (ETN) in RA (p<0.0001) and SpA (p=0.001), and between ADA and ETN in RA (p<0.0001) and SpA (p=0.002). For ADA, mean OR was 0.152 (95% CI: 0.054-0.427); for IFX, 0.144 (95% CI: 0.055-0.378); comparison was not significant (p=0.94). By disease, mean OR was 0.149 (95% CI: 0.064-0.347) in RA and 0.303 (95% CI: 0.103-0.890) in SpA; comparison was not significant. Methotrexate use reduced ADAb development in RA and SpA (OR=0.472; 95% CI: 0.324-0.689).
Discussion:
These findings confirm the immunogenic potential of TNF-α and support the use of methotrexate co-therapy. ADA and IFX showed similar immunogenicity profiles.
Conclusion:
ADAb were equally prevalent in RA and SpA. Immunogenicity was associated with treatment response and influenced by the use of methotrexate.
Related Concept Videos
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
T Cell Types and Functions
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Autoimmune Disorders
Concept and Mechanism of Autoimmune Diseases
The immune...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Rheumatic Heart Disease I: Introduction
Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...

