Serum Adalimumab Levels After Induction Are Associated With Long-Term Remission in Children With Inflammatory Bowel Disease

Frontiers in Pediatrics

article

Marianna Lucafò¹  Giuliana Decorti²  Debora Curci³  Matteo Bramuzzo⁴  Patrizia Alvisi⁵  Stefano Martelossi⁶  Tania Silvestri⁷  Veronica Guastalla²  Flavio Labriola⁵  Gabriele Stocco⁸ 

[1] Advanced Translational Diagnostics Laboratory, Institute for Maternal and Child Health Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Burlo Garofolo;Department of Medicine, and Health Sciences, University of Trieste;Reproductive and Developmental Sciences, University of Trieste;and Nutrition Unit, Institute for Maternal and Child Health-Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) “Burlo Garofolo”;Pediatric Gastroenterology Unit, Maggiore Hospital, Local health Centre (AUSL) Bologna;Pediatric Gastroenterology Unit, Cà Foncello Hospital;Single metropolitan laboratory (LUM) Autoimmunity and Allergy, Local Health Centre (AUSL) Bologna;Department of Life Sciences, University of Trieste

关键词: inflammatory bowel disease;    children;    adalimumab;    drug levels;    anti-TNF;    therapeutic drug monitoring;   

DOI  :  10.3389/fped.2021.646671

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Adalimumab is effective in inducing and maintaining remission in children with inflammatory bowel diseases (IBD). Therapeutic drug monitoring is an important strategy to maximize the response rates, but data on the association of serum adalimumab levels are lacking. This study aimed to assess the association of adalimumab concentrations at the end of induction and early during maintenance for long-term response. Materials and Methods: Serum samples for adalimumab level measurement were collected during routine visits between adalimumab administrations and therefore not necessarily at trough, both during the induction (week 4 ± 4) and maintenance phases (week 22 ± 4, 52 ± 4, and 82 ± 4). Adalimumab and anti-adalimumab antibodies were measured retrospectively using enzyme-linked immunosorbent assays (ELISA). Disease activity was determined by Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index. Results: Thirty-two children (median age 14.9 years) were enrolled. Sixteen, 15, 14, and 12 patients were in remission at weeks 4, 22, 52, and 82, respectively. Median adalimumab concentration was higher at all time points in patients achieving sustained clinical remission. Adalimumab levels correlated with clinical and biochemical variables. Adalimumab concentration above 13.85 and 7.54 μg/ml at weeks 4 and 22 was associated with remission at weeks 52 and 82. Conclusions: Adalimumab non-trough levels are associated with long-term response in pediatric patients with IBD.

【 授权许可】

CC BY