Correlation Between Anti-TNF Serum Levels and Endoscopic Inflammation in Inflammatory Bowel Disease Patients

Chaparro, M. ; Barreiro-de Acosta, M. ; Echarri, A. ; Almendros, R. ; Barrio, J. ; Llao, J. ; Gomollón, F. (Universidad de Zaragoza) ; Vera, M. ; Cabriada, J.L. ; Guardiola, J. ; Guerra, I. ; Beltrán, B. ; Roncero, O. ; Busquets, D. ; Taxonera, C. ; Calvet, X. ; Ferreiro-Iglesias, R. ; Ollero Pena, V. ; Bernardo, D. ; Donday, M.G. ; Garre, A. ; Godino, A. ; Díaz, A. ; Gisbert, J.P.

Resumen: 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.

Idioma: Inglés

DOI: 10.1007/s10620-018-5362-3

Año: 2018

Publicado en: DIGESTIVE DISEASES AND SCIENCES 64, 846 - 854 (2018), 1-9
ISSN: 0163-2116

Factor impacto JCR: 2.937 (2018)

Categ. JCR: GASTROENTEROLOGY & HEPATOLOGY rank: 48 / 84 = 0.571 (2018) - Q3 - T2

Factor impacto SCIMAGO: 1.292 - Physiology (Q1) - Gastroenterology (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/12-02557
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI13-00041
Financiación: info:eu-repo/grantAgreement/ES/MINECO/SAF2014-56642-JIN

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)