The engineered human anti-tumor necrosis factor-alpha antibody CDP571 inhibits inflammatory pathways but not T cell activation in patients with rheumatoid arthritis

Objective, We investigated the effect of an engineered human anti-tumor nec rosis facror-alpha antibody, CDP571, on immune functions as well as bone an d cartilage turnover in patients with rheumatoid arthritis (RA) in a placeb o controlled trial. We also assessed the effects of repeated treatment with CDP571 in an open label continuation study, Method, Thirty-six patients were created with either placebo or 0.1, 1, or 10 mg/kg of CDP571 given as an intravenous infusion. The followup period wa s 8 weeks. Lymphocyte phenotype, soluble CD4 (sCD4), soluble interleukin 2 receptor (sIL-2R), IL-6, and stromelysin levels in the blood were measured before and after treatment; bone and cartilage markers (pyridinoline, deoxy pyrirlinoline, N-terminal telopeptide) were similarly assessed in the urine . Patients who completed a placebo controlled trial of CDP571 were offered further treatment with CDP571, They received a maximum of 2 further doses o f 1 mg/kg (7 patients) or 10 mg/kg (9 patients) in an open study. Results. Plasma IL-6 level was statistically significantly reduced in the 1 and 10 mg/kg groups, In the 10 mg/kg group, there were also reductions in plasma stromelysin and urine bone markers, although there was no change in sCD4 and sIL-2R levels, Repeat doses of CDP571 were well tolerated and cont inued to suppress the acute phase response and disease activity. Conclusion. Treatment with 10 mg/kg of CDP571 reduced IL-6 and surrogate ma rkers of bone turnover in RA, suggesting chat CDP571 might prevent joint da mage in RA, Since there was no effect on lymphocyte markers despite the mar ked reduction in inflammation, CDP571 appears to have no effect on ongoing CD4 T cell activation.