Year 2024 / Volume 116 / Number 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,

Abstract
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.
Lay Summary
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.
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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


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Publication history

Received: 17/04/2024

Accepted: 29/07/2024

Online First: 01/08/2024

Published: 11/11/2024

Article revision time: 94 days

Article Online First time: 106 days

Article editing time: 208 days


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