Higher Adalimumab Trough Levels Are Associated with Histologic Remission and Mucosal Healing in Inflammatory Bowel Disease.
Higher Adalimumab Trough Levels Are Associated with Histologic Remission and Mucosal Healing in Inflammatory Bowel Disease.
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DOI：
10.3390/jcm12216796
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发表时间：
2023-10-27
影响因子：
3.9
通讯作者：
Battat R
中科院分区：
文献类型：
--
作者：
Wong R;Qin L;Pan Y;Mahtani P;Longman R;Lukin D;Scherl E;Battat R
(1) Many patients with inflammatory bowel disease (IBD) in endoscopic remission have persistent histologic activity, which is associated with worse outcomes. There are limited data on the association between adalimumab drug concentrations and histologic outcomes using validated histologic indices. We aimed to assess the relationship between adalimumab concentrations and the Robarts Histopathology Index (RHI). (2) Patients from a tertiary IBD center from 2013 to 2020 with serum adalimumab (ADA) trough concentrations measured during maintenance therapy (≥14 weeks) and a colonoscopy or flexible sigmoidoscopy with biopsies performed within 90 days of drug level were included. Blinded histologic scoring using the RHI was performed. Primary analysis assessed the relationship between adalimumab drug concentrations and histologic remission using receiver operating characteristic curve analysis. (3) In 36 patients (26 Crohn’s Disease, 9 ulcerative colitis, 1 indeterminate), median adalimumab concentrations were higher (17.3 ug/mL, 12.2–24.0) in patients with histologic remission compared to those without (10.3 ug/mL, 6.8–13.9, p = 0.008). The optimal ADA concentration identified using the Youden threshold was ≥16.3 ug/mL (sensitivity 70%, specificity 90%). Patients with ADA ≥ 16.3 ug/mL had higher histologic remission rates (78%) compared to lower ADA concentrations (14%, p= 0.002), as well as higher mucosal healing rates (86%) compared to lower levels (12%, p = 0.001). Symptoms correlated weakly and non-significantly with both histologic (RHI) scores (r = 0.25, p = 0.2) and adalimumab concentrations (r = 0.05, p = 0.8). (4) The current study demonstrated that higher serum adalimumab concentrations (≥16.3 ug/mL) are needed for histologic remission and mucosal healing assessed using the RHI.
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DOI：
10.1016/j.cgh.2019.11.056
发表时间：
2020-10
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Christensen B;Erlich J;Gibson PR;Turner JR;Hart J;Rubin DT
通讯作者：
Rubin DT
影响因子：
7.6
作者：
Papamichael K;Rakowsky S;Rivera C;Cheifetz AS;Osterman MT
通讯作者：
Osterman MT
影响因子：
3.1
作者：
Juncadella, Anna;Papamichael, Konstantinos;Cheifetz, Adam S.
通讯作者：
Cheifetz, Adam S.
影响因子：
29.4
作者：
Ma C;Sedano R;Almradi A;Vande Casteele N;Parker CE;Guizzetti L;Schaeffer DF;Riddell RH;Pai RK;Battat R;Sands BE;Rosty C;Dubinsky MC;Rieder F;Harpaz N;Abreu MT;Bryant RV;Lauwers GY;Kirsch R;Valasek MA;Crowley E;Sandborn WJ;Feagan BG;Pai RK;Jairath V
通讯作者：
Jairath V
影响因子：
4.3
作者：
Nakarai, Asuka;Kato, Jun;Yamamoto, Kazuhide
通讯作者：
Yamamoto, Kazuhide