Tu1289 Preventing Crohn's Disease Recurrence After Resection With Adalimumab: Role of Drug and Anti-Drug Antibody Levels
| Autor: | Michael A. Kamm, Amy L. Hamilton, Timothy H. Florin, H.S. Debinski, Steven J. Brown, Paul V. Desmond, Ian C. Lawrance, Ian Kronborg, Sharat Singh, Lani Prideaux, Graham L. Radford-Smith, Jane M. Andrews, Fabiyola Selvaraj, Kathryn J. Ritchie, Fred Princen, Danny Liew, Peter A. Bampton, William Connell, Peter R. Elliott, Richard B. Gearry, Douglas Samuel, Peter De Cruz, Emily K Wright, Efrosinia O. Krejany, Warwick Selby, Rodney Woods, Sally Bell, Alexandra Gorelik, Peter R. Gibson, Simon Jakobovits, Michael J. Johnston, Finlay A. Macrae |
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| Rok vydání: | 2015 |
| Předmět: |
Drug
medicine.medical_specialty Crohn's disease Hepatology business.industry medicine.medical_treatment media_common.quotation_subject Gastroenterology medicine.disease Anti-Drug Antibody Predictive value Resection Surgery Internal medicine medicine Clinical endpoint Adalimumab business Colectomy media_common medicine.drug |
| Zdroj: | Gastroenterology. 148:S-849 |
| ISSN: | 0016-5085 |
| Popis: | remission at 3 months did not then undergo colectomy, yet 3/6 (50%) not in remission did (p=0.07). Bivariate comparisons for primary and secondary endpoints are tabulated below. Also, ROC analysis showed that the area under curve (AUC) of consecutive day 1 to 3 levels for serum IFX (cutoff ≤158 μg/ml), CRP (≤33 mg/L) and FC (≤4910 μg/ml) each predicted the primary endpoint (6w) with a sensitivity & specificity of 83% & 71% (AUC 0.81 [95% CI 0.57, 1.0]), 83% & 57% (AUC 0.75 [0.41, 1.0]) and 83% & 100% (AUC 0.88 [0.66, 1.0] respectively. Conclusions: Post-first IFX dose in ASUC early higher CRP and FC levels predicted poorer week 6 outcomes. Yet unexpectedly, an early decrement in IFX levels from day 1 through day 3 appeared to confer better outcomes; this might reflect appropriate IFX binding/utilization in early responders compared to static levels in potential non-responders (e.g. where a non-TNF pathway predominates). Further prospective evaluation of the predictive value of Day 1-3 biomarkers in ASUC is warranted given these findings. |
| Databáze: | OpenAIRE |
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