评估抗英夫利昔单抗抗体（抗 IFX）对 3 个不同护理点的影响：对英夫利昔单抗 (IFX) 的反应/耐受性、逐渐减量策略以及随后使用第二种肿瘤坏死因子抑制剂 (TNFi) 的治疗。对 60 名接受 IFX 治疗的放射学中轴​​型脊柱关节炎 (r-axSpA) 患者进行前瞻性队列回顾性评估，评估基线时、6、12-14、22-24、48-54、96 后的临床/实验室数据、IFX 水平和抗 IFX。 -102 周以及逐渐减量或转换之前。27 名 (45%) 患者中检测到抗 IFX，其中 23 名 (85.1%) 在 IFX 治疗的第一年呈阳性。与抗 IFX 阴性组相比，抗 IFX 阳性患者表现出以下情况：较少使用甲氨蝶呤 (MTX) 作为 IFX 的伴随治疗（5 例 [18.5%] 对比 14 例 [42.4%]；p=0.048）； 22-24 周（p=0.020）和 48-54 周（p=0.034）输注反应较多； 48-54 周时治疗失败较多（p=0.028）；总体 IFX 生存率降低（p<0.001）；和较低的持续反应（p=0.044）。值得注意的是，与抗 IFX 阴性患者相比，抗 IFX 阳性患者的逐渐减量生存期较短（9.9 个月 [95% CI 4.0-15.8] vs 63.4 个月 [95% CI 27.9-98.8]；p=0.004）。相反，对于 IFX 失败的患者，抗 IFX 阳性患者在 3 个月（15 [83.3%] vs. 3 [27.3%]；p=0.005）和 6 个月（15 [83.3%]）时对第二次 TNFi 具有更好的临床反应vs. 4 [36.4%]；p=0.017) 比转用后抗 IFX 阴性患者高。这项研究提供了新的数据，表明抗 IFX 是减少逐渐减量生存的参数，加强了其检测以指导临床决策。此外，我们在长期队列中证实了抗 IFX 与较差的 IFX 性能相关，并作为第二个 TNFi 良好临床反应的预测因子。本文受版权保护。版权所有。

To evaluate the influence of anti-infliximab antibodies (anti-IFX) on 3 different points of care: response/tolerance to infliximab (IFX), tapering strategy, and in a subsequent treatment with a second tumor necrosis factor inhibitor (TNFi).A prospective cohort of 60 radiographic axial spondyloarthritis (r-axSpA) patients under IFX were evaluated retrospectively regarding clinical/laboratorial data, IFX levels and anti-IFX, at baseline, after 6, 12-14, 22-24, 48-54, 96-102 weeks and before tapering or switching.Anti-IFX were detected in 27 (45%) patients, of whom 23 (85.1%) became positive in the first year of IFX treatment. In comparison to negative anti-IFX group, anti-IFX positive patients demonstrated the following: less use of methotrexate (MTX) as a concomitant treatment to IFX (5 [18.5%] vs. 14 [42.4%]; p=0.048); more infusion reactions at 22-24 weeks (p=0.020) and 48-54 weeks (p=0.034); more treatment failures (p=0.028) at 48-54 weeks; reduced overall IFX survival (p<0.001); and lower sustained responses (p=0.044). Of note, positive anti-IFX patients exhibited a shorter tapering survival (9.9 months [95% CI 4.0-15.8] vs 63.4 months [95% CI 27.9-98.8]; p=0.004) in comparison with negative anti-IFX patients. Conversely, for patients who failed IFX, positive anti-IFX patients had better clinical response to the second TNFi at 3 (15 [83.3%] vs. 3 [27.3%]; p=0.005) and 6 months (15 [83.3%] vs. 4 [36.4%]; p=0.017) than the negative anti-IFX patients after switching.This study provided novel data that anti-IFX is a parameter for reduced tapering survival, reinforcing its detection to guide clinical decision. Additionally, we confirmed in a long-term cohort the anti-IFX association with worse IFX performance and as predictor of 2nd TNFi good clinical response.This article is protected by copyright. All rights reserved.