Año 2024 / Volumen 116 / Número 11
Original
Ultrasound transmural healing correlates with higher adalimumab drug concentration in Crohn’s disease only in the short-term

606-612

DOI: 10.17235/reed.2024.10489/2024

José Ramón Lorente, José María Paredes, Pilar Llopis, Tomás Ripollés, Alba Voces, Ángela Algarra, Carmina Asencio, Patricia Latorre, Nadia Moreno, Antonio López-Serrano, Eduardo Moreno-Osset,

Resumen
Background: anti-TNF drugs have revolutionized the treatment of Crohn’s disease (CD) and have set new therapeutic targets. A direct correlation between anti-TNF trough levels and endoscopic healing in inflammatory bowel disease (IBD) patients has been established, but the association between drug levels and transmural healing assessed by ultrasound is not yet clearly defined. Aims: to evaluate the correlation between the serum concentration of adalimumab (ADA) and sonographic transmural healing in CD patients at different times during follow-up. Methods: in this retrospective, cross-sectional study, all patients with CD who were undergoing treatment with ADA in our center were included. Intestinal ultrasound (IUS) was performed before the initiation of the drug and for response monitoring. ADA serum-trough levels were compared between patients with and without transmural healing at different periods of time. Results: ninety-two patients were included, and all patients showed signs of inflammatory activity in the baseline IUS. During IUS monitoring of the response to ADA, 34 (34.8 %) patients presented transmural healing. Among patients in the first year of treatment, those with sonographic healing showed higher median levels than patients without transmural healing (12.0 µg/ml vs 9.3 µg/ml, respectively; p = 0.007). There was no correlation between ADA levels and sonographic healing in patients undergoing treatment for over a year. Conclusions: higher ADA trough levels correlated with transmural healing with ultrasound during the first year of treatment. This correlation was not found after one year of treatment.
Resumen coloquial
Background: Anti-TNF drugs have revolutionized the treatment of Crohn’s disease and have set new therapeutic targets. It remains unclear whether higher plasma drug levels are associated with sonographic transmural healing. Aims: To evaluate the correlation between the serum concentration of adalimumab and sonographic transmural healing in Crohn’s disease patients at different times during follow-up. Methods: A retrospective study which included all patients with Crohn’s undergoing adalimumab in our center, performing plasma drug concentration and intestinal ultrasound before and after the initiation of the drug. Results: A third of patients showed transmural healing in the follow-up ultrasound. Patients in the first year of treatment showed higher drug levels when they had achieved transmural healing. This relationship was not found in patients undergoing treatment for over a year. Conclusions: Higher adalimumab serum levels were corelated with transmural healing with ultrasound during the first year of treatment. This correlation was not found after one year of treatment.
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1. Marsal J, Barreiro-de Acosta M, Blumenstein I, et al. Management of non-response and loss of response to anti-tumor necrosis factor therapy in inflammatory bowel disease. Front Med 2022;9:897-936.
2. Wilkens R, Novak KL, Maaser C, et al. Relevance of monitoring transmural disease activity in patients with Crohn´s disease: current status and future perspectives. Therap Adv Gastroenterol 2021;14:1-18.
3. Paredes JM, Moreno N, Latorre P, et al. Clinical impact of sonographic transmural healing after anti-TNF antibody treatment in patients with Crohn´s disease. Dig Dis Sci 2019;64:2600-2606.
4. Yarur AJ, Jain A, Hauenstein SI, et al. Higher adalimumab levels are associated with histologic and endoscopic remission in patients with Crohn's disease and ulcerative colitis. Inflamm Bowel Dis. 2016;22(2):409-15.
5. Ungar B, Ben-Shatach Z, Selinger L, et al. Lower adalimumab trough levels are associated with higher bowel wall thickness in Crohn´s disease. United European Gastroenterol J 2020;8:167-174.
6. Han ZM, Elodie WH, Yan LH, et al. Correlation between ultrasonographic response and anti-tumor necrosis factor drug levels in Crohn's disease. Ther Drug Monit. 2022;44:659-664.
7. Vaughan R, Murphy E, Nalder M, et al. Infliximab Trough Levels Are Associated With Transmural Sonographic Healing in Inflammatory Bowel Disease. Inflamm Bowel Dis. 2023;29(7):1080-1088.
8. Takenaka K, Kawamoto A, Kitazume Y, et al. Transmural Remission Characterized by High Biologic Concentrations Demonstrates Better Prognosis in Crohn's Disease. J Crohns Colitis. 2023;17(6):855-862.
9. Bossuyt P, Dreesen E, Rimola J, et al. Infliximab exposure associates with radiologic evidence of healing in patients with Crohn's disease. Clin Gastroenterol Hepatol. 2021;19:947-954.
10. Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl 1989;170:2-6.
11. Vermeire S, Schreiber S, Sandborn WJ, Dubois C, Rutgeerts P. Correlation between the Crohn’s disease activity and Harvey Bradshaw indices in assessing Crohn’s disease severity. Clin Gastroenterol Hepatol 2010;8:357-363.
12. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: an update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021;160:1570-1583.
13. Patriquin HB, Garcier JM, Lafortune M, et al. Appendicitis in children and young adults: Doppler sonographic-pathologic correlation. AJR Am J Roentgenol. 1996;166:629–633.
14. Ripollés T, Paredes JM, Martínez-Pérez MJ, et al. Ultrasonographic Changes at 12 Weeks of Anti-TNF Drugs Predict 1-year Sonographic Response and Clinical Outcome in Crohn's Disease: A Multicenter Study. Inflamm Bowel Dis. 2016;22:2465-73.
15. Vande Casteele N, Herfarth H, Katz J, et al. American Gastroenterological Association Institute technical review on the role of therapeutic drug monitoring in the management of inflammatory bowel diseases. Gastroenterology 2017;153:835-857.
16. Reenaers C, Bossuyt P, Hindryckx P, et al. Expert opinion for use of faecal calprotectin in diagnosis and monitoring of inflammatory bowel disease in daily clinical practice. United European Gastroenterol J 2018;6:1117- 1125.
17- Choi SY, Kwon Y, Choi S, et al. Infliximab trough levels are associated with endoscopic healing but not with transmural healing at one year treatment with infliximab in pediatric patients with Crohn's disease. Front Immunol. 2023;14:1192827.
18- Hanauer SB, Wagner CL, Bala M, et al. Incidence and importance of antibody responses to infliximab after maintenance or episodic treatment in Crohn's disease. Clin Gastroenterol Hepatol. 2004;2:542-53.
19- Schultheiss JPD, Mahmoud R, Louwers JM, et al. Loss of response to anti-TNFα agents depends on treatment duration in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2021;54:1298-1308.
20- Alsoud D, Verstockt B, Vermeire S. Letter: immunogenicity is not the root cause for loss of response to anti-TNF agents in patients with IBD in TDM era. Aliment Pharmacol Ther. 2022;55:885-886.
21- Chanchlani N, Lin S, Bewshea C, et al. Mechanisms and management of loss of response to anti-TNF therapy for patients with Crohn's disease: 3-year data from the prospective, multicentre PANTS cohort study. Lancet Gastroenterol Hepatol. 2024;9:521-538.
Artículos relacionados

Carta

Hyperbaric oxygen therapy for perianal Crohn’s disease

DOI: 10.17235/reed.2024.10378/2024

Carta

Secondary orofacial granulomatosis due to Crohn’s disease

DOI: 10.17235/reed.2024.10214/2023

Carta

Lung abscess in a non-compliant patient with Crohn’s disease

DOI: 10.17235/reed.2024.10140/2023

Carta

Coincidental oral lesions in Crohn’s disease

DOI: 10.17235/reed.2023.9992/2023

Imagen en Patología Digestiva

Intestinal and perianal tuberculosis: an uncommon clinical presentation and challenging diagnosis

DOI: 10.17235/reed.2022.8988/2022

Imagen en Patología Digestiva

Enfermedad de Crohn cutánea periostomal por contigüidad

DOI: 10.17235/reed.2022.8909/2022

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Carta al Editor

Adnexal localization of Crohn’s disease and recurrent massive ovary cysts

DOI: 10.17235/reed.2016.4301/2016

Caso Clínico

Enfermedad de Crohn metastásica en pediatría

DOI: 10.17235/reed.2016.3948/2015

Carta al Editor

Debut conjunto de enfermedad de Crohn y síndrome de Sweet

DOI: 10.17235/reed.2015.3842/2015

Caso Clínico

Afectación ovárica en la enfermedad de Crohn: una complicación rara

DOI: 10.17235/reed.2015.3764/2015

Instrucciones para citar
Lorente J, Paredes J, Llopis P, Ripollés T, Voces A, Algarra Á, et all. Ultrasound transmural healing correlates with higher adalimumab drug concentration in Crohn’s disease only in the short-term. 10489/2024


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 1525 veces.
Este artículo ha sido descargado 91 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 17/04/2024

Aceptado: 29/07/2024

Prepublicado: 01/08/2024

Publicado: 11/11/2024

Tiempo de revisión del artículo: 94 días

Tiempo de prepublicación: 106 días

Tiempo de edición del artículo: 208 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2025 y Creative Commons. Revista Española de Enfermedades Digestivas