The Relationship Between the Biosimilar (Ixifi®) Trough Level, and the Biomarkers Rheumatoid Factor, and Anti-Cyclic Citrullinated Peptide Antibody Levels in a Selected Sample of Iraqi Rheumatoid Arthritis Patients

Abstract

Rheumatoid arthritis is an inflammatory autoimmune disorder that affects large and small joints. Ixifi, a biosimilar medication, is produced from infliximab, a protein that targets Tumor Necrosis Factor-α exclusively. The study determines the effect of Ixifi trough level on disease activity, rheumatoid factor, and anti-cyclic citrullinated peptide antibody. A cross-sectional observational study, which included forty-two patients, who had a diagnosis of Rheumatoid arthritis. Three months after initiation of the Ixifi therapy, Ixifi level, CDAI, Anti-CCP, and RF biomarkers were determined. The Ixifi trough level was )5.45 ± 0.28µg/ml) in remission and )3.57 ± 0.14 µg/ml), (2.2 ± 0.17 µg/ml), and (0.66 ± 0.14µg/ml) in the mild, moderate, and severe groups, respectively. The Rheumatoid Factor serum level for the remission was (24.94 ± 0.92 IU/ml), mild was (35 ± 1.93 IU/ml), moderate and severe groups were (60.55 ±1.89 IU/ml) and (70 ±3.18 IU/ml), respectively. Anti-Cyclic Citrullinated Peptide, the serum level for the remission was (22.25 ±1.35 IU/ml), for the mild was (31±1.62 IU/ml), and for the moderate and severe groups was (57.18±2.54 IU/ml, and 67 ±2.3 IU/ml) respectively. The decrease in the Ixifi levels leads to an increase in disease severity and inflammation, whereas high concentrations of Ixifi decrease the disease activity, Rheumatoid Factor, and Anti-Cyclic Citrullinated Peptide Antibody Serum.