rather that over time and multiple switches you might develop neutralizing antibodies that might reduce efficacy.
Neutralizing antibodies could be developed over time even without switches. Is there any evidence patients who switched among several currently approved anti-TNF biologics are more likely to develop neutralizing antibody? I am not aware that at all.
For ERT Cerezyme, relatively high percentage (mid teens) of patients developed antibodies, and these patients had higher risk for hypersensitivity. That was one concern about switching among ERTs. So far no evidence of this at all.
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