M Chaparro1, I Guerra, P Muñoz-Linares, J P Gisbert. 1. Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Abstract
BACKGROUND: The associations between clinical efficacy and infusion reactions with anti-TNF-α drug levels and the presence of antibodies against the drug have been described. However, the clinical utility of these tests in routine clinical practice remains unclear. AIMS: To examine the clinical significance of the development of antibodies against anti-TNF-α drugs and the relationship between the efficacy of these drugs and their serum levels. We also studied the clinical utility of testing for anti-TNF-α antibodies and measuring drug serum levels to optimise treatment of patients with inflammatory bowel disease (IBD) receiving these agents. METHODS: A systematic review was undertaken based on electronic searches of the PubMed database from the earliest record to February 2012. The reference lists of all relevant articles and abstracts from meetings were also consulted. RESULTS: We observed a close relationship between trough levels of anti-TNF-α drug and maintenance of response to these drugs. The role of antibodies in loss of response seems to be limited to their effect favouring the clearance of the drug. The risk of infusion reactions, but not of delayed hypersensitivity reactions, is higher in patients with antibodies against the anti-TNF-α drug. Testing anti-TNF-α drug and antibody levels, together with clinical and endoscopic or radiological assessment, seems useful when attempting to optimise therapy and prevent inappropriate management of IBD patients. CONCLUSION: Measurement of serum anti-TNF-α trough levels and antibody titres could prove useful in therapeutic drug monitoring in IBD patients treated with anti-TNF-α agents.
BACKGROUND: The associations between clinical efficacy and infusion reactions with anti-TNF-α drug levels and the presence of antibodies against the drug have been described. However, the clinical utility of these tests in routine clinical practice remains unclear. AIMS: To examine the clinical significance of the development of antibodies against anti-TNF-α drugs and the relationship between the efficacy of these drugs and their serum levels. We also studied the clinical utility of testing for anti-TNF-α antibodies and measuring drug serum levels to optimise treatment of patients with inflammatory bowel disease (IBD) receiving these agents. METHODS: A systematic review was undertaken based on electronic searches of the PubMed database from the earliest record to February 2012. The reference lists of all relevant articles and abstracts from meetings were also consulted. RESULTS: We observed a close relationship between trough levels of anti-TNF-α drug and maintenance of response to these drugs. The role of antibodies in loss of response seems to be limited to their effect favouring the clearance of the drug. The risk of infusion reactions, but not of delayed hypersensitivity reactions, is higher in patients with antibodies against the anti-TNF-α drug. Testing anti-TNF-α drug and antibody levels, together with clinical and endoscopic or radiological assessment, seems useful when attempting to optimise therapy and prevent inappropriate management of IBDpatients. CONCLUSION: Measurement of serum anti-TNF-α trough levels and antibody titres could prove useful in therapeutic drug monitoring in IBDpatients treated with anti-TNF-α agents.
Authors: María Chaparro; Manuel Barreiro-de Acosta; Ana Echarri; Rosendo Almendros; Jesús Barrio; Jordina Llao; Fernando Gomollón; Maribel Vera; José Luis Cabriada; Jordi Guardiola; Iván Guerra; Belén Beltrán; Oscar Roncero; David Busquets; Carlos Taxonera; Xavier Calvet; Rocío Ferreiro-Iglesias; Virginia Ollero Pena; David Bernardo; María G Donday; Ana Garre; Ana Godino; Ana Díaz; Javier P Gisbert Journal: Dig Dis Sci Date: 2018-11-13 Impact factor: 3.199
Authors: Wael El-Matary; Thomas D Walters; Hien Q Huynh; Jennifer deBruyn; David R Mack; Kevan Jacobson; Mary E Sherlock; Peter Church; Eytan Wine; Matthew W Carroll; Eric I Benchimol; Sally Lawrence; Anne M Griffiths Journal: Inflamm Bowel Dis Date: 2019-01-01 Impact factor: 5.325
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