• Dig. Dis. Sci. · Mar 2019

    Multicenter Study

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

    • 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, and Javier P Gisbert.
    • Servicio de Aparato Digestivo, Hospital Universitario de La Princesa e Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain. mariachs2005@gmail.com.
    • Dig. Dis. Sci. 2019 Mar 1; 64 (3): 846-854.

    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 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.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 3.4 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.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.

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