María Chaparro1,2, Manuel Barreiro-de Acosta3, Ana Echarri4, Rosendo Almendros5, Jesús Barrio6, Jordina Llao7, Fernando Gomollón8,9, Maribel Vera10, José Luis Cabriada11, Jordi Guardiola12, Iván Guerra13, Belén Beltrán14,9, Oscar Roncero15, David Busquets16, Carlos Taxonera17, Xavier Calvet18,9, Rocío Ferreiro-Iglesias3, Virginia Ollero Pena4, David Bernardo19,9, María G Donday19,9, Ana Garre19,9, Ana Godino20, Ana Díaz20, Javier P Gisbert19,9. 1. Servicio de Aparato Digestivo, Hospital Universitario de La Princesa e Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. mariachs2005@gmail.com. 2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. mariachs2005@gmail.com. 3. Servicio de Aparato Digestivo, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain. 4. Servicio de Aparato Digestivo, Complejo Hospitalario Universitario de Ferrol, Coruña, Spain. 5. Servicio de Farmacia, Hospital Universitario Rio Hortega, Valladolid, Spain. 6. Servicio de Aparato Digestivo, Hospital Universitario Rio Hortega, Valladolid, Spain. 7. Servicio de Aparato Digestivo, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 8. Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa and IIS-Aragón, Saragossa, Spain. 9. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. 10. Servicio de Aparato Digestivo, Hospital Universitario Puerta de Hierro, Majadahonda, Spain. 11. Servicio de Aparato Digestivo, Hospital Galdakao-Usansolo, Vizcaya, Spain. 12. Servicio de Aparato Digestivo, Hospital Universitari de Bellvitge-IDIBELL, Universidad de Barcelona, Barcelona, Spain. 13. Servicio de Aparato Digestivo, Hospital Universitario de Fuenlabrada, Madrid, Spain. 14. Servicio de Aparato Digestivo, Hospital Universitari La Fe, Valencia, Spain. 15. Servicio de Aparato Digestivo, Complejo Hospitalario la Mancha Centro, Ciudad Real, Spain. 16. Servicio de Aparato Digestivo, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain. 17. Servicio de Aparato Digestivo, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 18. Servicio de Aparato Digestivo, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain. 19. Servicio de Aparato Digestivo, Hospital Universitario de La Princesa e Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. 20. Servicio de Análisis Clínicos, Hospital Universitario de La Princesa e Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain.
Abstract
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.
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 IBDpatients treated with anti-TNF. METHODS: This is a multicenter, prospective study. IBDpatients 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 IBDpatients; however, the accuracy of the determination of infliximab and adalimumab concentrations able to predict mucosal healing was suboptimal.
Authors: Andres J Yarur; Anjali Jain; Scott I Hauenstein; Maria A Quintero; Jamie S Barkin; Amar R Deshpande; Daniel A Sussman; Sharat Singh; Maria T Abreu Journal: Inflamm Bowel Dis Date: 2016-02 Impact factor: 5.325
Authors: Niels Vande Casteele; Marc Ferrante; Gert Van Assche; Vera Ballet; Griet Compernolle; Kristel Van Steen; Steven Simoens; Paul Rutgeerts; Ann Gils; Séverine Vermeire Journal: Gastroenterology Date: 2015-02-24 Impact factor: 22.682
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Fernando Gomollón; Axel Dignass; Vito Annese; Herbert Tilg; Gert Van Assche; James O Lindsay; Laurent Peyrin-Biroulet; Garret J Cullen; Marco Daperno; Torsten Kucharzik; Florian Rieder; Sven Almer; Alessandro Armuzzi; Marcus Harbord; Jost Langhorst; Miquel Sans; Yehuda Chowers; Gionata Fiorino; Pascal Juillerat; Gerassimos J Mantzaris; Fernando Rizzello; Stephan Vavricka; Paolo Gionchetti Journal: J Crohns Colitis Date: 2016-09-22 Impact factor: 9.071
Authors: L R Sutherland; F Martin; S Greer; M Robinson; N Greenberger; F Saibil; T Martin; J Sparr; E Prokipchuk; L Borgen Journal: Gastroenterology Date: 1987-06 Impact factor: 22.682
Authors: T Nunes; M J Etchevers; E Domènech; V García-Sánchez; Y Ber; M Peñalva; O Merino; P Nos; E Garcia-Planella; A G Casbas; M Esteve; C Taxonera Samsó; M Montoro Huguet; J P Gisbert; M D Martín Arranz; M F García-Sepulcre; M Barreiro-de Acosta; B Beltrán; N Alcaide Suárez; C Saro Gismera; J L Cabriada; A Cañas-Ventura; F Gomollón; J Panés Journal: Aliment Pharmacol Ther Date: 2013-08-26 Impact factor: 8.171