Usefulness of monitoring antitumor necrosis factor serum levels during the induction phase in patients with Crohn's disease.

Autor:	Chaparro M; Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP).; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)., Guerra I; Gastroenterology Unit, Hospital Universitario de Fuenlabrada, Madrid., Iborra M; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).; Gastroenterology Unit, Hospital Universitario de La Fe, Valencia., Cabriada JL; Gastroenterology Unit, Hospital Universitario de Galdakano, Vizcaya., Bujanda L; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).; Gastroenterology Unit, Hospital Universitario de Donostia, Instituto Biodonostia, Guipúzcoa., Taxonera C; Gastroenterology Unit, Hospital Universitario Clínico San Carlos and IdISSC, Madrid., García-Sánchez V; Gastroenterology Unit, Hospital Universitario Reina Sofía, Córdoba., Marín-Jiménez I; Gastroenterology Unit, Hospital Universitario Gregorio Marañón e IiSGM, Madrid., Barreiro-de Acosta M; Gastroenterology Unit, Hospital Universitario Clínico de Santiago, Santiago de Compostela., Vera I; Gastroenterology Unit, Hospital Universitario Puerta de Hierro Majadahonda., Martín-Arranz MD; Gastroenterology Unit, Hospital Universitario La Paz, Madrid., Hernández-Breijo B; Universidad de Alcalá de Henares, Alcalá de Henares., Mesonero F; Gastroenterology Unit, Hospital Universitario Ramón y Cajal, Madrid., Sempere L; Gastroenterology Unit, Hospital Universitario Alicante, Alicante., Gomollón F; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).; Gastroenterology Unit, Hospital Universitario Clínico, Zaragoza., Hinojosa J; Gastroenterology Unit, Hospital Universitario Manises, Valencia, Spain., Bermejo F; Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP)., Beltrán B; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).; Gastroenterology Unit, Hospital Universitario de La Fe, Valencia., Rodríguez Pescador A; Gastroenterology Unit, Hospital Universitario de Galdakano, Vizcaya., Banales JM; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).; Gastroenterology Unit, Hospital Universitario de Donostia, Instituto Biodonostia, Guipúzcoa., Olivares D; Gastroenterology Unit, Hospital Universitario Clínico San Carlos and IdISSC, Madrid., Aguilar-Melero P; Gastroenterology Unit, Hospital Universitario Reina Sofía, Córdoba., Menchén L; Gastroenterology Unit, Hospital Universitario Gregorio Marañón e IiSGM, Madrid., Ferreiro-Iglesias R; Gastroenterology Unit, Hospital Universitario Clínico de Santiago, Santiago de Compostela., Blazquez Gomez I; Gastroenterology Unit, Hospital Universitario Puerta de Hierro Majadahonda., Benítez García B; Gastroenterology Unit, Hospital Universitario La Paz, Madrid., Guijarro LG; Universidad de Alcalá de Henares, Alcalá de Henares., Marin A; Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP).; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)., Bernardo D; Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP).; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)., Gisbert JP; Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP).; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
Jazyk:	angličtina
Zdroj:	European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2020 May; Vol. 32 (5), pp. 588-596.
DOI:	10.1097/MEG.0000000000001706
Abstrakt:	Aims: The aims of this study were (a) to know the kinetics of antitumor necrosis factor (TNF) drug serum levels during the induction phase in patients with Crohn's disease; (b) to identify variables associated with these levels; and (c) to assess the relation between these levels and short-term effectiveness in Crohn's disease patients. Methods: Patients with Crohn's disease naïve to anti-TNF treatment were prospectively included. Remission was defined as a Crohn's disease activity index (CDAI) score <150 after 14 weeks of treatment. Blood samples were obtained at baseline and at weeks 4, 8, and 14. Adalimumab and infliximab levels were measured, receiver operating characteristic (ROC) curves were constructed, and the area under the ROC curve was calculated. Results: One-hundred fifty patients with Crohn's disease were included, 79 (53%) received infliximab and 71 (47%) had CDAI > 150 at study entry. At week 14, 52 out of 71 patients with CDAI > 150 at baseline (73%) had clinical remission. There were no differences in infliximab levels between patients with and without remission (8 vs. 9.1 μg/mL, P > 0.05) or with and without response (7 vs. 11 μg/mL, P > 0.05) at week 14. There was a trend to higher levels of adalimumab concentration in responders in comparison with nonresponders (13 vs. 6.7 μg/mL, P = 0.05) and in patients who achieved remission in comparison with nonremitters (13.5 vs. 8.4 μg/mL, P = 0.06). In the multivariate analysis, no variable was predictive of short-term remission, including infliximab and adalimumab serum levels. Conclusion: Determining anti-TNF serum levels during the induction phase is not useful for predicting short-term remission in patients with Crohn's disease.
Databáze:	MEDLINE
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