Comparison of two different techniques to assess adalimumab trough levels in patients with Crohn’s disease

Giorgia Bodini, Edoardo G. Giannini, Manuele Furnari, Elisa Marabotto, Isabella Baldissarro, Lorenzo Del Nero, Lorenzo Assandri, Alessandro Moscatelli, Vincenzo Savarino, Edoardo Savarino

Research output: Contribution to journalArticle

Abstract

Background & Aims: Loss of response to anti-tumor necrosis factor (TNF) drugs in patients with inflammatory bowel disease is likely due to low drug serum levels, and dosing anti-TNF drug concentrations may improve patients’ outcome. However, there are limited data on the diagnostic accuracy and utility of currently available assays for measuring anti-TNF levels. In this study, our aim was to compare serum adalimumab concentrations with two different techniques. Methods: We assessed serum adalimumab concentrations in 23 patients with Crohn’s disease during a 96-week follow-up period. Adalimumab trough levels were assessed using a sandwich principle-based enzyme-linked immunosorbent assay (ELISA) and a homogeneous mobility shift assay (HMSA). Results: At week 48, adalimumab trough levels were significantly lower in patients who experienced relapse compared to patients in remission, using both ELISA and HMSA methods: 4.8 mcg/mL (2.4-7.2 mcg/mL) vs. 7.5 mcg/mL (6.6-8.4 mcg/mL) (P=0.01) and 6.5 mcg/mL (3-10 mcg/mL) vs. 11.6 mcg/mL (7-16.2 mcg/ml) (P=0.004), respectively. Similar results were obtained at week 96: 5.9 mcg/mL (3.3-8.5 mcg/mL) vs. 12.8 mcg/mL (9.4-16.2 mcg/mL) (P=0.001) and 4.1 mcg/mL (1.6-6.6 mcg/mL) vs. 7.5 mcg/mL (5.7-9.3 mcg/mL) (P=0.009), respectively. There was a significant correlation between ELISA and HMSA adalimumab trough levels at both 48 (r = 0.691, P=0.0003) and 96 week (r = 0.822, P=0.0001). Conclusions: ELISA and HMSA assays are accurate methods to assess adalimumab trough levels in patients with Crohn’s disease and those who experience loss of response. The preferential use of one of the two techniques should be based on local availability and physicians’ experience.

Original languageEnglish
Pages (from-to)451-456
Number of pages6
JournalJournal of Gastrointestinal and Liver Diseases
Volume24
Issue number4
DOIs
Publication statusPublished - Dec 1 2015

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Keywords

  • ELISA
  • HMSA
  • Inflammatory bowel disease
  • Loss of response

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Bodini, G., Giannini, E. G., Furnari, M., Marabotto, E., Baldissarro, I., Nero, L. D., Assandri, L., Moscatelli, A., Savarino, V., & Savarino, E. (2015). Comparison of two different techniques to assess adalimumab trough levels in patients with Crohn’s disease. Journal of Gastrointestinal and Liver Diseases, 24(4), 451-456. https://doi.org/10.15403/jgld.2014.1121.244.adb