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Details

Autor(en) / Beteiligte
Titel
Correlation Between Anti-TNF Serum Levels and Endoscopic Inflammation in Inflammatory Bowel Disease Patients
Ist Teil von
  • Digestive diseases and sciences, 2019-03, Vol.64 (3), p.846-854
Ort / Verlag
New York: Springer US
Erscheinungsjahr
2019
Link zum Volltext
Quelle
SpringerLink (Online service)
Beschreibungen/Notizen
  • Objectives (a) To evaluate the diagnostic accuracy of anti-TNF trough levels to predict mucosal healing in inflammatory bowel disease (IBD); (b) to determine the best cut-off point to predict mucosal healing in IBD patients treated with anti-TNF. Methods This is a multicenter, prospective study. IBD patients under anti-TNF treatment for at least 6 months that had to undergo an endoscopy were included. Mucosal healing was defined as: Simple endoscopic score for Crohn’s Disease < 3 for Crohn’s disease (CD), Rutgeerts score < i2 for CD in postoperative setting, or Mayo endoscopic score ≤ 1 for ulcerative colitis (UC). Anti-TNF concentrations were measured using SMART ELISAs at trough. Results A total of 182 patients were included. Anti-TNF trough levels were significantly higher among patients that had mucosal healing than among those who did not. The area under the curve of infliximab for mucosal healing was 0.63 (best cutoff value 3.4 μg/mL), and for adalimumab 0.60 (best cutoff value 7.2 μg/mL). In the multivariate analysis, having anti-TNF drug levels above the cutoff values [odds ratio (OR) 3.1]) and having UC instead of CD (OR 4) were associated with a higher probability of having mucosal healing. Additionally, the need for an escalated dosage (OR 0.2) and current smoking habit (OR 0.2) were also associated with a lower probability of mucosal healing. Conclusions There was an association between anti-TNF trough levels and mucosal healing in IBD patients; however, the accuracy of the determination of infliximab and adalimumab concentrations able to predict mucosal healing was suboptimal.
Sprache
Englisch
Identifikatoren
ISSN: 0163-2116
eISSN: 1573-2568
DOI: 10.1007/s10620-018-5362-3
Titel-ID: cdi_proquest_miscellaneous_2133439332
Format
Schlagworte
Adalimumab, Adalimumab - blood, Adalimumab - pharmacokinetics, Adalimumab - therapeutic use, Adult, Analysis, Anti-Inflammatory Agents - blood, Anti-Inflammatory Agents - pharmacokinetics, Anti-Inflammatory Agents - therapeutic use, Biochemistry, Biological Products - blood, Biological Products - pharmacokinetics, Biological Products - therapeutic use, Care and treatment, Clinical medicine, Colitis, Ulcerative - blood, Colitis, Ulcerative - diagnosis, Colitis, Ulcerative - drug therapy, Colitis, Ulcerative - immunology, Colonoscopy, Crohn Disease - blood, Crohn Disease - diagnosis, Crohn Disease - drug therapy, Crohn Disease - immunology, Drug dosages, Drug Monitoring - methods, Endoscopy, Endoscopy, Gastrointestinal, Enzyme-Linked Immunosorbent Assay, Female, Gastroenterology, Hepatology, Hospitals, Humans, Immunotherapy, Inflammation, Inflammatory bowel disease, Infliximab - blood, Infliximab - pharmacokinetics, Infliximab - therapeutic use, Intestinal Mucosa - drug effects, Intestinal Mucosa - immunology, Intestinal Mucosa - pathology, Male, Medical research, Medicine, Medicine & Public Health, Medicine, Experimental, Middle Aged, Monoclonal antibodies, Oncology, Original Article, Predictive Value of Tests, Prospective Studies, Spain, Time Factors, TNF inhibitors, Transplant Surgery, Treatment Outcome, Tumor necrosis factor, Tumor Necrosis Factor-alpha - antagonists & inhibitors, Tumor Necrosis Factor-alpha - immunology, Tumor necrosis factor-TNF, Ulcerative colitis, Wound Healing - drug effects

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