Assays for the detection of anti-TNF drugs and autoantibodies
The present invention provides assays for detecting and measuring the presence or level of anti-TNFα drug therapeutics and autoantibodies in a sample. The present invention is useful for optimizing therapy and monitoring patients receiving anti-TNFα drug therapeutics to detect the presence or level of autoantibodies (e.g., HACA and/or HAHA) against the drug.
1. A method for optimizing therapy and/or reducing toxicity to an anti-TNFα drug in a subject receiving therapy with said anti-TNFα drug, said method comprising:
(a) measuring the level of said anti-TNFα drug in a first sample from said subject, wherein said anti-TNFα drug is measured with an assay comprising:
(i) contacting said first sample with an amount of a labeled TNFα to form a first complex comprising said labeled TNFα with said anti-TNFα drug; and
detecting an amount of said first complex by size exclusion chromatography and comparing the amount detected to a standard curve of known amounts of the anti-TNFα drug, thereby measuring said level of said anti-TNFα drug;
(b) measuring the level of an autoantibody to said anti-TNFα drug in a second sample from said subject; and
(c) determining a subsequent course of therapy for said subject based upon the levels of said anti-TNFα drug and said autoantibody,
thereby optimizing therapy and/or reducing toxicity to said anti-TNFα drug.
2. The method of claim 1 , wherein the subsequent course of therapy comprises co-administering an immunosuppressive drug with said anti-TNFα drug when said level of said anti-TNFα drug is a high level and said level of said autoantibody is a low level.
3. The method of claim 1 , wherein the subsequent course of therapy comprises increasing the level of said anti-TNFα drug and co-administering an immunosuppressive drug when said level of said anti-TNFα drug is a medium level and said level of said autoantibody is a low level.
4. The method of claim 1 , wherein the subsequent course of therapy comprises administering a different anti-TNFα drug when said level of said anti-TNFα drug is a medium level and said level of said autoantibody is a medium level.
5. The method of claim 1 , wherein the subsequent course of therapy comprises administering a different anti-TNFα drug when said level of said anti-TNFα drug is a low level and said level of said autoantibody is a high level.
6. The method of claim 4 , wherein adalimumab is administered instead of infliximab.
7. The method of claim 1 , wherein said autoantibody is measured with an assay comprising:
(i) contacting said second sample with an amount of a labeled anti-TNFα drug to form a second complex comprising said labeled anti-TNFα drug with said autoantibody; and
(ii) detecting said second complex by size exclusion chromatography, thereby measuring said level of said autoantibody.
8. The method claim 1 , wherein said anti-TNFα drug is a member selected from the group consisting of infliximab, etanercept, adalimumab, certolizumab pegol, and combinations thereof.
9. The method of claim 1 , wherein said anti-TNFα drug is infliximab.
10. The method of claim 1 , wherein said anti-TNFα drug is adalimumab.
11. The method of claim 1 , wherein said anti-TNFα drug is etanercept.
12. The method of claim 1 , wherein said anti-TNFα drug is certolizumab pegol.
13. The method of claim 1 , wherein said measured anti-TNFα drug is quantitated.
14. The method of claim 1 , wherein said measured autoantibody is quantitated.
15. The method of claim 1 , wherein both of said first and second samples are serum samples.
16. The method of claim 1 , wherein both of said first and second samples are obtained from said subject during therapy with said anti-TNFα drug.
17. The method of claim 1 , wherein said autoantibody is a member selected from the group consisting of human anti-mouse antibody (HAMA), human anti-chimeric antibody (HACA), human anti-humanized antibody (HAHA), and combinations thereof.
18. The method of claim 2 , wherein said immunosuppressive drug is selected from the group consisting of methotrexate, azathioprine, metabolites thereof, and combinations thereof.
19. The method of claim 2 , wherein said level of said anti-TNFα drug is between about 10 to about 50 ng/10 μl and said level of said autoantibody is between about 0.1 to about 2.0 ng/10 μl.
20. The method of claim 3 , wherein said level of said anti-TNFα drug is between about 5.0 to about 20 ng/10 μl and said level of said autoantibody is between about 0.1 to about 2.0 ng/10 μl.
21. The method of claim 4 , wherein said level of said anti-TNFα drug is between about 5.0 to about 20 ng/10 μl and said level of said autoantibody is between about 0.5 to about 10 ng/10 μl.
22. The method of claim 5 , wherein said level of said anti-TNFα drug is between 0 to about 5 ng/10 μl and said level of said autoantibody is between about 3.0 to about 50 ng/10 μl.