P347 Undetectable levels of adalimumab in clinical practice: Should we say goodbye to the drug?
| Autor: | L Tortosa Seguí, J L Poveda, Renato Francisco Rodrigues Marques, A Garrido Marín, D Muñoz Gómez, G Bastida Paz, E Valero Pérez, J Del Hoyo Francisco, S Bejar, P Nos Mateu, Mariam Aguas |
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| Rok vydání: | 2020 |
| Předmět: |
Drug
Crohn's disease medicine.medical_specialty medicine.diagnostic_test business.industry media_common.quotation_subject Gastroenterology General Medicine medicine.disease Ulcerative colitis Inflammatory bowel disease Therapeutic drug monitoring Internal medicine medicine Adalimumab Combined Modality Therapy Hypoalbuminemia business media_common medicine.drug |
| Zdroj: | Journal of Crohn's and Colitis. 14:S333-S333 |
| ISSN: | 1876-4479 1873-9946 |
| Popis: | Background Therapeutic drug monitoring (TDM) is used in inflammatory bowel disease to guide dosing of biologics to individualise drug exposure and optimise outcomes. In case of undetectable levels of Adalimumab (levels Methods Since October 13 to August 19, 758 TDM were performed in 260 patients treated with ADA. We selected the patients who had at least a level Results We identified 46 patients with undetectable levels; 12 were excluded. Thirty-four patients were included, 29 (85.3%) with Crohn’s disease and 5 (14.7%) with ulcerative colitis. Ten (29.4%) patients had combined treatment and 17 (50%) had previously received another anti-TNF. In 24 (70.6%) TDM was performed proactively. After detection of levels 5 μg/ml), 12 (60%) in the intensified-patient group and 2 (14.3%) in the group in whom the treatment was not modified. ADA was withdrawn in 13 patients (32.8%) after a mean time of 358 days (SD 258). The ADA maintenance rate (HR=3.88; 95% CI 1.2–12.4; p = 0.02) and the recovery ratio of ADA levels (HR = 6.75; 95% CI 1.1–39, 8; p = 0.03) was higher in the intensified group. Hypoalbuminemia was associated with an earlier withdrawal of ADA (p = 0.03) Conclusion The intensification of ADA in patients with IBD and undetectable plasma concentrations allows recovery of levels and maintenance of the drug in a high percentage of patients. The decision to withdraw treatment in patients with undetectable levels should be individualised. |
| Databáze: | OpenAIRE |
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