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Clinical and laboratory markers associated with anti-TNF-alpha trough levels and anti-drug antibodies in patients with inflammatory bowel diseases

机译：与炎症性肠疾病患者的抗TNF-α槽水平和抗药物抗体相关的临床和实验室标志物

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Monitoring anti-TNF agents in inflammatory bowel disease (IBD) patients may be helpful in optimizing outcomes. We aimed to evaluate potential correlations among demographic, clinical, laboratory, or imaging parameters, as well as serum levels of infliximab (IFX) and adalimumab (ADA) and their respective antibodies, in the clinical management of IBD patients. A cross-sectional study of 95 patients with Crohn's disease (CD) or ulcerative colitis (UC) in maintenance therapy with infliximab or adalimumab was performed. Drug trough levels and anti-drug levels were determined using ELISA-based assays. Regarding the serum IFX dosage, patients with higher relative C-reactive protein (CRP) levels had significantly lower relative serum IFX levels (3 μg/mL) ( P = .028). In contrast, higher concentrations of anti-IFX antibodies were found in patients who were not on concomitant immunomodulators ( P = .022) and who had more biological-related adverse events ( P = .001) and higher levels of CRP ( P = .042). Serum CRP levels were also negatively correlated with IFX (CC = ?0.315; P = .033) but positively correlated with the presence of IFX antibodies (CC = 0.327; P = .027). Serum albumin dosage showed a positive correlation with levels of both IFX (CC = 0.379; P = .004) and ADA (CC = 0.699; P = .003). Although anti-TNF-α trough levels and immunogenicity do not show a significant correlation with disease outcome, our results reinforce the use of combination therapy for patients treated with infliximab . Moreover, we confirmed the presence of significant associations between anti-TNF-α trough levels and immunogenicity with body mass index (BMI), the concomitant use of immunomodulators, the rates of side effects, and laboratory markers, including serum albumin and CRP.
机译：监测炎症性肠病（IBD）患者的抗TNF剂可能有助于优化结果。我们旨在评估人口统计学，临床，实验室或影像学参数的潜在相关性，以及IBD患者的临床管理中的人口统计学，临床，实验室或成像参数，以及血清昔单抗（IFX）和ADALIMILAB（ADA）及其各自的抗体。进行95例CROHN病（CD）或溃疡性结肠炎（UC）与英美昔单抗的溃疡性结肠炎（UC）的横截面研究。使用基于ELISA的测定法测定药物槽水平和抗药物水平。关于血清IFX剂量，相对C反应蛋白（CRP）水平较高的患者具有显着较低的相对血清IFX水平（<3μg/ mL）（p = .028）。相比之下，在不在伴随免疫调节剂（P = 0.022）的患者中发现了较高浓度的抗IFX抗体（P = .022），并且具有更多的生物学相关不良事件（P = .001）和更高水平的CRP（P =。 042）。血清CRP水平也与IFX（CC = 0.315; p = .033）负相关，但与IFX抗体存在呈正相关（CC = 0.327; p = .027）。血清白蛋白剂量显示出与IFX（CC = 0.379; P = .004）和ADA（CC = 0.699; P = .003）的水平的正相关。虽然抗TNF-α槽水平和免疫原性与疾病结果没有显着相关性，但我们的结果加强了对用英夫利昔单抗治疗的患者的组合治疗的使用。此外，我们确认存在抗TNF-α槽水平和免疫原性与体重指数（BMI）之间的显着关联的存在，伴随使用免疫调节剂，副作用率和实验室标志物，包括血清白蛋白和CRP。

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