Abstract | BACKGROUND: AIMS: To assess the association between random serum ADL levels and clinical or biochemical remission with clinical decision making in daily practice according to these levels; and to determine the cutoff value for successful dose reduction in patients with IBD treated with ADL. METHODS: We conducted a prospective observational study of patients with IBD who received long-term maintenance therapy with ADL. RESULTS: Data were available for 157 serum samples from 87 patients. Serum ADL levels were associated with clinical remission: median 9.2 versus 6.0 μg/mL for patients with Crohn's disease with active disease (P = 0.009) and 14.4 versus 5.2 μg/mL in patients with ulcerative colitis with active disease (P = 0.002). Serum ADL levels were 9.2 μg/mL for patients with a normal C-reactive protein value (<5 mg/L) and 5.2 μg/mL for patients with a high C-reactive protein value (P = 0.002). ADL levels were significantly associated with normal fecal calprotectin value (<80 ng/g) (10.8 versus 7.6 μg/mL, respectively, P = 0.038). Serum ADL levels were significantly associated with successful deintensification, over a 6-month period of clinical follow-up, compared with the group in which doses remained unchanged (area under the curve 0.88; 95% confidence interval, 0.81-0.95; P < 0.001), with a cutoff value for successful deintensification of 12.2 μg/mL. CONCLUSIONS: Higher ADA levels were significantly associated with clinical and biochemical remission. Our results, which were obtained under conditions of daily clinical practice, suggest that an ADL cutoff of 12.2 μg/mL could be appropriate for successful dose reduction in patients with IBD treated with ADL.
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Authors | Mariam Aguas Peris, Virginia Bosó, Belén Navarro, Maria R Marqués-Miñana, Guillermo Bastida, Belén Beltrán, Marisa Iborra, Esteban Sáez-González, Emilio Monte-Boquet, Jose L Poveda-Andrés, Pilar Nos |
Journal | Inflammatory bowel diseases
(Inflamm Bowel Dis)
Vol. 23
Issue 8
Pg. 1454-1460
(08 2017)
ISSN: 1536-4844 [Electronic] England |
PMID | 28708805
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Gastrointestinal Agents
- Tumor Necrosis Factor-alpha
- Adalimumab
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Topics |
- Adalimumab
(blood, therapeutic use)
- Adult
- Biomarkers
(blood)
- Female
- Follow-Up Studies
- Gastrointestinal Agents
(blood, therapeutic use)
- Humans
- Inflammatory Bowel Diseases
(blood, drug therapy, pathology)
- Maintenance Chemotherapy
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- Remission Induction
- Severity of Illness Index
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
- Young Adult
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