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Brief Report
Available online 23 December 2021
Anti-TNFα drug levels in patients with rheumatoid arthritis and spondyloarthritis
Niveles de fármacos anti-TNFα en pacientes con artritis reumatoide y espondiloartritis
Erardo Meriño-Ibarra
Corresponding author

Corresponding author.
, Francisco Javier Manero Ruíz
Servicio de Reumatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
Received 07 September 2020. Accepted 03 June 2021
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Tables (2)
Table 1. Summary of variables assessed, by rheumatic disease.
Table 2. Anti-TNF drug levels in standard-dose patients. A: Overall results. B: Anti-TNF drug levels according to rheumatic disease and according to remission/low disease activity vs. no remission/no low disease activity. C: Drug levels according to treatment with DMARDs and C1 according to rheumatic disease.
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Background and objectives

Knowledge of the levels of anti-TNFa drugs can modify treatment in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).


To compare the levels of anti-TNFa in patients with RA vs SpA, in different clinical situations.

Materials and methods

A retrospective, observational study was conducted. Levels of anti-TNFa and the presence of anti-drug antibodies were measured in consecutively selected patients, using the ELISA technique.


Fifty-three, 73 and 78 patients treated with infliximab, adalimumab and etanercept were studied, respectively. The median drug levels in patients using standard doses were infliximab 2.2 µg/mL (1.4–5.2), adalimumab 4.9 µg/mL (0.8−8.9) and etanercept 3.1 µg/mL (2.3−4.4). There were no differences in drug levels according to disease activity but we found differences in etanercept and infliximab levels according to DMARD use.


Levels of anti-TNFa drugs will change with DMARD treatment.

Anti-TNFα levels
Rheumatoid arthritis
Antecedentes y objetivos

El conocimiento de los niveles de fármacos anti-TNFα puede modificar el tratamiento en pacientes con artritis reumatoide (AR) y espondiloartritis (EspA).


Comparar los niveles de anti-TNFα en pacientes con AR vs EspA, en diferentes situaciones clínicas.

Materiales y métodos

Se realizó un estudio retrospectivo, observacional donde se midieron los niveles de anti-TNFα y la presencia de anticuerpos antifármacos en pacientes seleccionados consecutivamente, utilizando la técnica de ELISA.


Se estudiaron 53, 73 y 78 pacientes en tratamiento con infliximab, adalimumab y etanercept, respectivamente. Los niveles medios de fármaco en pacientes con dosis estándar fueron: infliximab 2,2 μg/mL (1,4–5,2), adalimumab 4,9 μg/mL (0,8−8,9) y etanercept 3,1 μg/mL (2,3–4,4). No se encontraron diferencias en los niveles fármacos según la actividad de la enfermedad, sin embargo, hubo diferencias en los niveles de etanercept e infliximab según el uso de fármacos modificadores de la enfermedad sintéticos (FAMEsc).


Los niveles de fármacos anti-TNFα se verán modificados por el tratamiento con FAMEsc.

Palabras clave:
Niveles de anti-TNFα
Artritis reumatoide


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