BACKGROUND: In Crohn's disease, higher adalimumab trough levels and negative anti-adalimumab-antibodies associate with better clinical and endoscopic outcomes. Intestinal ultrasound has become a relevant non-invasive method to monitor treatment. However, data on the association between adalimumab levels and bowel wall thickness measured with ultrasound is limited. OBJECTIVE: The purpose of this study was to examine the possible association between the sonographic transmural-thickness and adalimumab trough levels. METHODS: This prospective observational cohort study was conducted at Sheba Medical Center in 2014-2018. Crohn's disease patients on adalimumab maintenance therapy with intestinal ultrasound performed within <30 days of trough level measurement were included. Associations between terminal ileum and colonic thickness, adalimumab levels and therapy retention were assessed. RESULTS: Fifty events of ultrasound with concomitant adalimumab trough level measurements in 44 Crohn's disease patients were included. Patients with trough level <3 μg/ml had significantly higher bowel wall thickness, both for terminal ileum (p = 0.04) and colon (p = 0.02). Thirty-two patients continued adalimumab therapy over one year. The adalimumab retention rate was higher among those with terminal ileum thickness <4 mm (p = 0.03). CONCLUSION: Lower adalimumab trough levels were associated with higher bowel wall thickness indicating poorer therapy outcome. Transmural thickness measurement with ultrasound may be a useful target for guiding biologic therapy in Crohn's disease.
BACKGROUND: In Crohn's disease, higher adalimumab trough levels and negative anti-adalimumab-antibodies associate with better clinical and endoscopic outcomes. Intestinal ultrasound has become a relevant non-invasive method to monitor treatment. However, data on the association between adalimumab levels and bowel wall thickness measured with ultrasound is limited. OBJECTIVE: The purpose of this study was to examine the possible association between the sonographic transmural-thickness and adalimumab trough levels. METHODS: This prospective observational cohort study was conducted at Sheba Medical Center in 2014-2018. Crohn's diseasepatients on adalimumab maintenance therapy with intestinal ultrasound performed within <30 days of trough level measurement were included. Associations between terminal ileum and colonic thickness, adalimumab levels and therapy retention were assessed. RESULTS: Fifty events of ultrasound with concomitant adalimumab trough level measurements in 44 Crohn's diseasepatients were included. Patients with trough level <3 μg/ml had significantly higher bowel wall thickness, both for terminal ileum (p = 0.04) and colon (p = 0.02). Thirty-two patients continued adalimumab therapy over one year. The adalimumab retention rate was higher among those with terminal ileum thickness <4 mm (p = 0.03). CONCLUSION: Lower adalimumab trough levels were associated with higher bowel wall thickness indicating poorer therapy outcome. Transmural thickness measurement with ultrasound may be a useful target for guiding biologic therapy in Crohn's disease.
Authors: Konstantinos Karmiris; Gilles Paintaud; Maja Noman; Charlotte Magdelaine-Beuzelin; Marc Ferrante; Danielle Degenne; Karolien Claes; Tamara Coopman; Nele Van Schuerbeek; Gert Van Assche; Severine Vermeire; Paul Rutgeerts Journal: Gastroenterology Date: 2009-08-05 Impact factor: 22.682
Authors: Y Mazor; R Almog; U Kopylov; D Ben Hur; A Blatt; A Dahan; M Waterman; S Ben-Horin; Y Chowers Journal: Aliment Pharmacol Ther Date: 2014-07-15 Impact factor: 8.171
Authors: Casper Steenholdt; Jørn Brynskov; Ole Østergaard Thomsen; Lars Kristian Munck; Jan Fallingborg; Lisbet Ambrosius Christensen; Gitte Pedersen; Jens Kjeldsen; Bent Ascanius Jacobsen; Anne Sophie Oxholm; Jakob Kjellberg; Klaus Bendtzen; Mark Andrew Ainsworth Journal: Gut Date: 2013-07-22 Impact factor: 23.059
Authors: Xavier Roblin; M Rinaudo; E Del Tedesco; J M Phelip; C Genin; L Peyrin-Biroulet; S Paul Journal: Am J Gastroenterol Date: 2014-06-10 Impact factor: 10.864