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Évaluation comparative de 4 différents tests immunologiques commercialisés dans le suivi thérapeutique pharmacologique de l’Infliximab et de l'Adalimumab
Mémoire de Master / Thèse d'exercice   Open Access

Évaluation comparative de 4 différents tests immunologiques commercialisés dans le suivi thérapeutique pharmacologique de l’Infliximab et de l'Adalimumab

Florian Rissel
Masters , Université de Montpellier
20/10/2023

Résumé

Therapeutic drug monitoring Immunoassays comparison Immunodosage Anti-TNF-alpha Immunologie Antidrug antibodies Monitorage thérapeutique des médicaments Essais immunologiques comparatifs Anticorps anti-médicaments Suivi thérapeutique pharmacologique Adalimumab Infliximab Anticorps monoclonaux
Therapeutics drug monitoring (TDM) of anti-TNF-α is an important tool in clinical practice for inflammatory diseases. In this study, we have evaluated the performance of several assays for drug and antidrug antibodies (ADA) measurement in the serum. 50 sera from patients treated with Infliximab (IFX) and 49 sera from patients treated with Adalimumab (ADAL) were monitored with four immunosays. We have compared Promonitor, i-Track10®, and ez-track1 assays to our gold standard Lisa Tracker® ELISA using Cohen's kappa, Passing-Bablok, and Bland-Altman analysis. The qualitative analysis evaluated by Cohen's kappa values found for IFX measurements an "almost perfect" concordance for Promonitor, "moderate" for i-Track10® and "substantial" for ez-track1. For ADAL, kappa values were "moderate" for all tested methods. For anti-IFX, kapa values were "almost perfect" for all three assays. For anti-ADAL, kappa values were "almost perfect" for all three assays. For quantitative analysis of drug measurements, Pearson's r values were all above 0.9 and Lin's concordance coefficients of all immunoassays were around 0.80. Performances of the four evaluated immunoassays were acceptable for TDM based on our laboratory experience. Nevertheless, concordance between the four methods for IFX measurement was not perfect and we recommend the use of the same assay for the follow-up of a given patient. The performances of the four immunoassays evaluated were similar and are acceptable for TDM based on our laboratory experience.

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