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

被引：24

作者：

Chaparro, Maria ^{[1
,2
,21
]}

Barreiro-de Acosta, Manuel ^{[2
,3
]}

Echarri, Ana ^{[4
]}

Almendros, Rosendo ^{[5
]}

Barrio, Jesus ^{[6
]}

Llao, Jordina ^{[7
]}

Gomollon, Fernando ^{[8
,9
,21
]}

Vera, Maribel ^{[10
]}

Luis Cabriada, Jose ^{[11
]}

Guardiola, Jordi ^{[12
]}

Guerra, Ivan ^{[13
]}

Beltran, Belen ^{[14
,21
]}

Roncero, Oscar ^{[15
]}

Busquets, David ^{[16
]}

Taxonera, Carlos ^{[17
,18
]}

Calvet, Xavier ^{[19
,21
]}

Ferreiro-Iglesias, Rocio ^{[2
,3
]}

Ollero Pena, Virginia ^{[4
]}

Bernardo, David ^{[1
,2
,21
]}

Donday, Maria G. ^{[1
,2
,21
]}

Garre, Ana ^{[1
,2
,21
]}

Godino, Ana ^{[2
,20
]}

Diaz, Ana ^{[2
,20
]}

Gisbert, Javier P. ^{[1
,2
,21
]}

机构：

[1] Hosp Univ La Princesa, Serv Aparato Digest, Madrid, Spain

[2] Inst Invest Sanitaria Princesa IIS IP, Madrid, Spain

[3] Hosp Clin Univ Santiago, Serv Aparato Digest, Santiago De Compostela, Spain

[4] Complejo Hosp Univ Ferrol, Serv Aparato Digest, Coruna, Spain

[5] Hosp Univ Rio Hortega, Serv Farm, Valladolid, Spain

[6] Hosp Univ Rio Hortega, Serv Aparato Digest, Valladolid, Spain

[7] Hosp Santa Creu & Sant Pau, Serv Aparato Digest, Barcelona, Spain

[8] Hosp Clin Univ Lozano Blesa, Serv Aparato Digest, Zaragoza, Spain

[9] IIS Aragon, Zaragoza, Spain

[10] Hosp Univ Puerta de Hierro, Serv Aparato Digest, Majadahonda, Spain

[11] Hosp Galdakao Usansolo, Serv Aparato Digest, Vizcaya, Spain

[12] Univ Barcelona, IDIBELL, Hosp Univ Bellvitge, Serv Aparato Digest, Barcelona, Spain

[13] Hosp Univ Fuenlabrada, Serv Aparato Digest, Madrid, Spain

[14] Hosp Univ La Fe, Serv Aparato Digest, Valencia, Spain

[15] Complejo Hosp la Mancha Ctr, Serv Aparato Digest, Ciudad Real, Spain

[16] Hosp Univ Girona Doctor Josep Trueta, Serv Aparato Digest, Girona, Spain

[17] Hosp Clin San Carlos, Serv Aparato Digest, Madrid, Spain

[18] Hosp Clin San Carlos IdISSC, Inst Invest, Madrid, Spain

[19] Corp Sanitaria Parc Tauli, Serv Aparato Digest, Barcelona, Spain

[20] Hosp Univ La Princesa, Serv Anal Clin, Madrid, Spain

[21] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

来源：

DIGESTIVE DISEASES AND SCIENCES | 2019年 / 64卷 / 03期

关键词：

Anti-TNF; Tumor necrosis factor alpha; Trough levels; Mucosal healing; Infliximab; Adalimumab; Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; LONG-TERM DURABILITY; CROHNS-DISEASE; ULCERATIVE-COLITIS; INFLIXIMAB; ADALIMUMAB; ASSOCIATION; THERAPY; ANTIBODIES;

D O I：

10.1007/s10620-018-5362-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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.MethodsThis is a multicenter, prospective study. IBD patients under anti-TNF treatment for at least 6months 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 score1 for ulcerative colitis (UC). Anti-TNF concentrations were measured using SMART ELISAs at trough.ResultsA 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 3.4g/mL), and for adalimumab 0.60 (best cutoff value 7.2g/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.ConclusionsThere 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.

引用

页码：846 / 854

页数：9

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