Usefulness of monitoring antitumor necrosis factor serum levels during the induction phase in patients with Crohn's disease
Por:
Chaparro, M, Guerra, I, Iborra, M, Cabriada, J, Bujanda, L, Taxonera, C, Garcia-Sanchez, V, Marin-Jimenez, I, Barreiro-de Acosta, M, Vera, I, Martin-Arranz, M, Hernandez-Breijo, B, Mesonero, F, Sempere, L, Gomollon, F, Hinojosa, J, Bermejo, F, Beltran, B, Pescador, A, Banales, J, Olivares, D, Aguilar-Melero, P, Menchen, L, Ferreiro-Iglesias, R, Gomez, I, Garcia, B, Guijarro, L, Marin, A, Bernardo, D, Gisbert, J and PREDICROHN Study Grp GETECCU
Publicada:
1 may 2020
Resumen:
Aims
The aims of this study were (a) to know the kinetics of antitumor necrosis factor (TNF) drug serum levels during the induction phase in patients with Crohn's disease; (b) to identify variables associated with these levels; and (c) to assess the relation between these levels and short-term effectiveness in Crohn's disease patients.
Methods
Patients with Crohn's disease naive to anti-TNF treatment were prospectively included. Remission was defined as a Crohn's disease activity index (CDAI) score <150 after 14 weeks of treatment. Blood samples were obtained at baseline and at weeks 4, 8, and 14. Adalimumab and infliximab levels were measured, receiver operating characteristic (ROC) curves were constructed, and the area under the ROC curve was calculated.
Results
One-hundred fifty patients with Crohn's disease were included, 79 (53%) received infliximab and 71 (47%) had CDAI > 150 at study entry. At week 14, 52 out of 71 patients with CDAI > 150 at baseline (73%) had clinical remission. There were no differences in infliximab levels between patients with and without remission (8 vs. 9.1 mu g/mL, P > 0.05) or with and without response (7 vs. 11 mu g/mL, P > 0.05) at week 14. There was a trend to higher levels of adalimumab concentration in responders in comparison with nonresponders (13 vs. 6.7 mu g/mL, P = 0.05) and in patients who achieved remission in comparison with nonremitters (13.5 vs. 8.4 mu g/mL, P = 0.06). In the multivariate analysis, no variable was predictive of short-term remission, including infliximab and adalimumab serum levels.
Conclusion
Determining anti-TNF serum levels during the induction phase is not useful for predicting short-term remission in patients with Crohn's disease.
Filiaciones:
Chaparro, M:
Hosp Univ La Princesa, Gastroenterol Unit, Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Guerra, I:
Hosp Univ Fuenlabrada, Gastroenterol Unit, Madrid, Spain
Iborra, M:
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ La Fe, Gastroenterol Unit, Valencia, Spain
Cabriada, J:
Hosp Univ Galdakano, Gastroenterol Unit, Vizcaya, Spain
Bujanda, L:
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Donostia, Inst Biodonostia, Gastroenterol Unit, Guipuzcoa, Spain
Taxonera, C:
Hosp Univ Clin San Carlos, Gastroenterol Unit, Madrid, Spain
IdISSC, Madrid, Spain
Garcia-Sanchez, V:
Hosp Univ Reina Sofia, Gastroenterol Unit, Cordoba, Spain
Marin-Jimenez, I:
Hosp Univ Gregorio Maranon, Gastroenterol Unit, Madrid, Spain
IiSGM, Madrid, Spain
Barreiro-de Acosta, M:
Hosp Univ Clin Santiago, Gastroenterol Unit, Santiago De Compostela, Spain
Vera, I:
Hosp Univ Puerta de Hierro Majadahonda, Gastroenterol Unit, Madrid, Spain
Martin-Arranz, M:
Hosp Univ La Paz, Gastroenterol Unit, Madrid, Spain
Hernandez-Breijo, B:
Univ Alcala de Henares, Alcala De Henares, Spain
Mesonero, F:
Hosp Univ Ramon y Cajal, Gastroenterol Unit, Madrid, Spain
:
Hosp Univ Alicante, Gastroenterol Unit, Alicante, Spain
Gomollon, F:
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Clin, Gastroenterol Unit, Zaragoza, Spain
Hinojosa, J:
Hosp Univ Manises, Gastroenterol Unit, Valencia, Spain
Bermejo, F:
Hosp Univ La Princesa, Gastroenterol Unit, Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain
Beltran, B:
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ La Fe, Gastroenterol Unit, Valencia, Spain
Pescador, A:
Hosp Univ Galdakano, Gastroenterol Unit, Vizcaya, Spain
Banales, J:
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Donostia, Inst Biodonostia, Gastroenterol Unit, Guipuzcoa, Spain
Olivares, D:
Hosp Univ Clin San Carlos, Gastroenterol Unit, Madrid, Spain
IdISSC, Madrid, Spain
Aguilar-Melero, P:
Hosp Univ Reina Sofia, Gastroenterol Unit, Cordoba, Spain
Menchen, L:
Hosp Univ Gregorio Maranon, Gastroenterol Unit, Madrid, Spain
IiSGM, Madrid, Spain
Ferreiro-Iglesias, R:
Hosp Univ Clin Santiago, Gastroenterol Unit, Santiago De Compostela, Spain
Gomez, I:
Hosp Univ Puerta de Hierro Majadahonda, Gastroenterol Unit, Madrid, Spain
Garcia, B:
Hosp Univ La Paz, Gastroenterol Unit, Madrid, Spain
Guijarro, L:
Univ Alcala de Henares, Alcala De Henares, Spain
Marin, A:
Hosp Univ La Princesa, Gastroenterol Unit, Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Bernardo, D:
Hosp Univ La Princesa, Gastroenterol Unit, Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Gisbert, J:
Hosp Univ La Princesa, Gastroenterol Unit, Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain
Hosp Univ Fuenlabrada, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
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