Anti drug antibodies in response to biological drugs

[Fred]

I was just reading TL's comment about anti drug antibodies in response to biological drugs here: RE: Cosentyx for psoriatic arthritis Fred's journey and it's interesting.

I had often thought my body somehow just gets used to my current treatment and it stops working, but I never understood (and still don't really) exactly what was going on. But there is a lot out there about "Anti drug antibodies" and it does make some interesting reading.

Here is how I see it.

#1 My body is making too much of one cell and I get psoriasis, then as it gets worse I also get psoriatic arthritis.

#2 I take a treatment that bombards me with a cell to try and slow down the process and I feel better.

#3 My body then starts to fight against the treatment as it now sees it as a threat.

So eventually there is a high likelihood that my body will eventually get used to the treatment and stop it working.

Thoughts anyone ?

[Turnedlight]

That’s pretty much how I understood it, I also (worryingly) read that if you take methotrexate alongside the bio it makes your body take much longer to make anti drug antibodies. Not small doses of mtx either.

I haven’t had this suggested to me when being prescribed the bios. However, that might be partly to do with the fact I’ve made my feelings clear on mtx and it did in fact stop working on me after about a year, just like bios do.

[Fred]

It's also interesting reading our own poll Longest time on a successful treatment for psoriasis

[Caroline]

Well yes, your body is making antibodies to the medication. That is correct.
I have seen an interview with Anna-Christa de Vries (dermatologist), that says that e.g. infliximab (Remicade) gives a cause to the build up of anti bodies which is different from etanercept (Enbrel), which does this hardly.

So indeed it is your own body who is doing that. And as Turnedlight says, by suppressing the immune system they try to prevent the building up of these antibodies. Over here a study is running, done by Gayle van der Kraaij, to combine Humira with MTX.

What I understand from biologicals is probably not enough, but it is kind of an enzyme that is attaching to the receptors of the Cell. If it attaches to the IL-17 receptors, then for most people this will have an effect on Psoriatic Arthritis. Practically it switches off part of the immune system. In reality this is all far more complex. Bet let’s try to keep it simple.
So it is the body that at a certain point makes antibodies to the blocking enzyme so it loses its efficacy. This is why there can be more bio’s that target the same receptor. E.g Taltz is a different enzyme, but it also binds to the IL-17 receptor.
This is as far as I can make sense out of it.

That is a reason why I am in favor of my beloved DMF. For most people it takes a very very long time to build antibodies for it, so you can use it for a very long time. I have spoken several people who have stated that DMF stopped working for them, but I have also spoken to people who are using it endlessly, up to 35 years, jim and Bill are examples of it. I guess the reason of that is that because fumarates are a substance that is known to the system, they are part of the energy cycle of the cell, which means that the building of the antibodies will not happen.

[jiml]

Thanks Caroline I think I understand better now, yes dmf has been good to me so far and hopefully I won't develop antibodies to it for many years

[Fred]

Oh no the DMF gang are in town, time to leave.

[Caroline]

Oh no the DMF gang are in town, time to leave.