Higher Adalimumab Drug Levels During Maintenance Therapy for Crohn's Disease Are Associated With Biologic Remission
| Autor: | Cher S Chuah, Ian D. Arnott, Gwo-Tzer Ho, Shahida Din, Charlie W. Lees, Mathew Lyons, Lynne M Merchant, Eleanor F Watson, Colin L. Noble, Gareth R. Jones, Alan G. Shand, Nikolas Plevris, Rebecca J Pattenden, Philip Jenkinson |
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| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
0301 basic medicine Drug Adult Male medicine.medical_specialty media_common.quotation_subject Anti-Inflammatory Agents Gastroenterology Maintenance Chemotherapy 03 medical and health sciences 0302 clinical medicine Maintenance therapy Crohn Disease Internal medicine Adalimumab Immunology and Allergy Medicine Humans Prospective Studies skin and connective tissue diseases media_common Crohn's disease medicine.diagnostic_test business.industry Remission Induction Odds ratio Middle Aged medicine.disease Prognosis Confidence interval 030104 developmental biology Cross-Sectional Studies Therapeutic drug monitoring 030211 gastroenterology & hepatology Female Calprotectin business medicine.drug Follow-Up Studies |
| Zdroj: | Inflammatory bowel diseases. 25(6) |
| ISSN: | 1536-4844 |
| Popis: | Adalimumab is an established treatment for Crohn's disease. Limited data are available regarding the relationship between adalimumab drug levels and serum/fecal markers of gut inflammation. We therefore aimed to characterize the relationship between adalimumab levels and biologic remission during maintenance therapy.A single-center prospective cross-sectional study was undertaken on Crohn's disease patients who had received adalimumab therapy for a minimum of 12 weeks after induction. Data on clinical activity (Harvey-Bradshaw Index), C-reactive protein (CRP), adalimumab drug and antibody levels, and fecal calprotectin were collected. Biologic remission was defined as a CRP5 mg/L and fecal calprotectin250 µg/g. Adalimumab drug and antibody levels were processed using the Immundiagnostik monitor enzyme-linked immunosorbent assay.One hundred fifty-two patients had drug and antibody samples matched with CRP and fecal calprotectin. Patients in biologic remission had significantly higher adalimumab levels compared with others (12.0 µg/mL vs 8.0 µg/mL, P0.0001). Receiver operating characteristic curve analysis demonstrated an optimal adalimumab level of8.5 µg/mL (sensitivity, 82.2%; specificity, 55.7%; likelihood ratio, 1.9) for predicting biologic remission. Multivariable logistic regression revealed that adalimumab levels8.5 µg/mL were independently associated with biologic remission (odds ratio, 5.27; 95% confidence interval, 2.43-11.44; P0.0001).Higher adalimumab levels are associated with biologic remission. An optimal level of8.5 µg/mL was identified. |
| Databáze: | OpenAIRE |
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