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Full Text:
http://ibd-rc.com/articles/low-seru...l-recurrence-crohns-disease-patients/fulltext
From the discussion part:
"The main strengths of our study are the systematic evaluation of clinical, endoscopic and radiologic disease activity in all patients, with a standardized follow-up, and the prospective collection of blood samples at consecutive time points. Furthermore, this is the first investigation aimed to assess the impact of pharmacokinetics of anti-TNF in the postoperative setting."
ABSTRACT
Background
Whether therapeutic drug monitoring of biologic therapy can predict the efficacy of adalimumab to prevent postoperative Crohn's disease recurrence is unknown.
Aim
To investigate whether adalimumab trough levels and anti-adalimumab antibodies correlate with endoscopic and clinical outcomes in a series of patients treated with prophylactic adalimumab monotherapy after resective surgery.
Methods
Post hoc analysis of a randomized, mesalamine-controlled trial. Adalimumab trough levels and antibodies were analysed every 8 weeks for 2 years using an homogeneous mobility shift assay.
Results
At two years, 1/6 patient had clinical recurrence and 1/6 patient had endoscopic and clinical recurrence. At baseline (9.5 vs. 14.4 mcg/mL) and during follow-up [7.5 (4.4–9.8) vs. 13.9 (8.9–23.6) mcg/mL,p < 0.01], median adalimumab trough levels in patients with clinical or endoscopic recurrence were lower than in those who maintained remission. Persistent antibodies-against-adalimumab were detected in the patient with both endoscopic and clinical recurrence.
Conclusion
Measurement of adalimumab trough levels and anti-adalimumab antibodies after surgery could be useful to further reduce postoperative recurrence.
http://ibd-rc.com/articles/low-seru...l-recurrence-crohns-disease-patients/fulltext
From the discussion part:
"The main strengths of our study are the systematic evaluation of clinical, endoscopic and radiologic disease activity in all patients, with a standardized follow-up, and the prospective collection of blood samples at consecutive time points. Furthermore, this is the first investigation aimed to assess the impact of pharmacokinetics of anti-TNF in the postoperative setting."
ABSTRACT
Background
Whether therapeutic drug monitoring of biologic therapy can predict the efficacy of adalimumab to prevent postoperative Crohn's disease recurrence is unknown.
Aim
To investigate whether adalimumab trough levels and anti-adalimumab antibodies correlate with endoscopic and clinical outcomes in a series of patients treated with prophylactic adalimumab monotherapy after resective surgery.
Methods
Post hoc analysis of a randomized, mesalamine-controlled trial. Adalimumab trough levels and antibodies were analysed every 8 weeks for 2 years using an homogeneous mobility shift assay.
Results
At two years, 1/6 patient had clinical recurrence and 1/6 patient had endoscopic and clinical recurrence. At baseline (9.5 vs. 14.4 mcg/mL) and during follow-up [7.5 (4.4–9.8) vs. 13.9 (8.9–23.6) mcg/mL,p < 0.01], median adalimumab trough levels in patients with clinical or endoscopic recurrence were lower than in those who maintained remission. Persistent antibodies-against-adalimumab were detected in the patient with both endoscopic and clinical recurrence.
Conclusion
Measurement of adalimumab trough levels and anti-adalimumab antibodies after surgery could be useful to further reduce postoperative recurrence.
