PMID- 30483525
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240403
IS  - 2397-9070 (Electronic)
IS  - 2397-9070 (Linking)
VI  - 1
IP  - 1
DP  - 2017 Sep
TI  - Positive relationship between infliximab and adalimumab trough levels at 
      completion of induction therapy with clinical response rates, at a tertiary 
      referral center.
PG  - 4-10
LID - 10.1002/jgh3.12000 [doi]
AB  - BACKGROUND AND AIM: Anti-tumor necrosis factor alpha (TNFalpha) therapies have 
      improved outcomes for patients with inflammatory bowel disease. The aim of this 
      study was to explore the relationship between infliximab (IFX) and adalimumab 
      (ADL) trough and antibody levels with clinical response rates at the end of 
      induction. METHODS: This was a prospective, single-center study. Patients were 
      recruited from July 2015 to August 2016. Inclusion criteria were all inflammatory 
      bowel disease patients older than 17 years who started treatment with IFX or ADL. 
      Baseline clinical disease activity indexes were performed. Clinical response was 
      defined as HBI </=3 or partial Mayo score </=4% or <30% reduction from baseline. 
      Anti-TNFalpha trough and antibody levels were measured using standard ELISA 
      techniques. RESULTS: Thirty-five patients were recruited, of whom 23 had Crohn's 
      disease and 12 had ulcerative colitis. Eighteen were treated with ADL and 17 with 
      IFX. The mean age of the cohort was 40.3 years, 62.9% were females, 34.3% were on 
      concomitant thiopurines, and 25.7% had prior anti-TNFalpha exposure. Overall response 
      rate was 51.4%, 33.3% for ADL and 70.6% for IFX.Mean trough levels were 12.5 
      mug/mL for IFX and 4.4 mug/mL for ADL. There was a clear link between higher 
      anti-TNFalpha trough levels at the end of induction with clinical response rates. For 
      IFX, mean trough level was 16.4 mug/mL for responders versus 5.3 mug/mL for 
      non-responders (P = 0.026). Area under the curve for association of IFX level at 
      induction with clinical response was 0.864 (P = 0.0001). Similar link was present 
      between higher ADL levels with clinical response, although not statistically 
      significant. CONCLUSION: Higher trough levels at the end of induction are 
      associated with improved response. Ongoing work will define optimal targets at 
      this key timeframe.
FAU - Tighe, Donal
AU  - Tighe D
AUID- ORCID: 0000-0001-8847-9914
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
FAU - Smith, Sinead
AU  - Smith S
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
FAU - O'Connor, Anthony
AU  - O'Connor A
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
FAU - Breslin, Niall
AU  - Breslin N
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
FAU - Ryan, Barbara
AU  - Ryan B
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
FAU - McNamara, Deirdre
AU  - McNamara D
AD  - Department of Gastroenterology, Tallaght Hospital and School of Medicine Trinity 
      College Dublin Dublin Ireland.
LA  - eng
PT  - Journal Article
DEP - 20170918
PL  - Australia
TA  - JGH Open
JT  - JGH open : an open access journal of gastroenterology and hepatology
JID - 101730833
PMC - PMC6207032
OTO - NOTNLM
OT  - Crohn's disease
OT  - adalimumab
OT  - antibody
OT  - anti-tumor necrosis factor alpha
OT  - inflammatory bowel disease
OT  - infliximab
OT  - trough
OT  - ulcerative colitis
EDAT- 2017/09/18 00:00
MHDA- 2017/09/18 00:01
PMCR- 2017/09/18
CRDT- 2018/11/29 06:00
PHST- 2017/07/12 00:00 [received]
PHST- 2017/07/26 00:00 [accepted]
PHST- 2018/11/29 06:00 [entrez]
PHST- 2017/09/18 00:00 [pubmed]
PHST- 2017/09/18 00:01 [medline]
PHST- 2017/09/18 00:00 [pmc-release]
AID - JGH312000 [pii]
AID - 10.1002/jgh3.12000 [doi]
PST - epublish
SO  - JGH Open. 2017 Sep 18;1(1):4-10. doi: 10.1002/jgh3.12000. eCollection 2017 Sep.