{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:43:52Z","timestamp":1761061432453,"version":"3.41.2"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009560","name":"American Gastroenterological Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009560","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Digestive Diseases Research Center","award":["NIH DK120515"],"award-info":[{"award-number":["NIH DK120515"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Therapeutic drug monitoring (TDM) with measurement of serum drug and antidrug antibody concentrations is used to optimize tumor necrosis factor antagonists (anti-TNF). The endoscopic healing index (EHI) is a validated serum-based assay to measure mucosal inflammation in adults with Crohn disease (CD). Our objectives were to evaluate the relationship between EHI and TDM results and to determine the anti-TNF concentration range associated with EHI &amp;lt;20 (consistent with endoscopic remission).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Adult and pediatric patients with CD (N = 1731) were selected retrospectively from a clinical laboratory cohort. Patients were selected if they had an ICD-10 code for CD and if results for EHI and TDM were available within 30 days of each other. The relationship between EHI and TDM results was examined and the anti-TNF concentration range associated with EHI &amp;lt;20 vs &amp;gt;50 was evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median anti-TNF concentration was higher in patients with EHI &amp;lt;20 vs &amp;gt;50 for infliximab (N = 796): 11.1 vs 3.4 \u00b5g\/mL and for adalimumab (N = 935): 9.2 vs 5.0 \u00b5g\/mL (P &amp;lt; 0.0001 both drugs). Patients with antibodies to infliximab (12.8%) or adalimumab (14.9%) had lower anti-TNF concentrations (P &amp;lt; 0.001 both drugs) and higher EHI (P &amp;lt; 0.01 both drugs). The concentration range for infliximab: 5\u201315 \u00b5g\/mL (5\u20139 \u00b5g\/mL in pediatric patients) and for adalimumab: 5\u201310 \u00b5g\/mL (8 \u00b5g\/mL in pediatric patients) best discriminated EHI &amp;lt;20 vs &amp;gt;50.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We report the anti-TNF concentration range associated with EHI &amp;lt;20. Combined testing of EHI and TDM is proposed as a noninvasive approach for treat-to-target management which could improve the ability to monitor disease and optimize anti-TNF therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/crocol\/otab035","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T03:08:32Z","timestamp":1622948912000},"source":"Crossref","is-referenced-by-count":1,"title":["Noninvasive Targeted Crohn Disease Management by Combining Endoscopic Healing Index and Therapeutic Drug Monitoring"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-222X","authenticated-orcid":false,"given":"Amy","family":"Hemperly","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Gastroenterology, University of California San Diego , La Jolla, California , USA"},{"name":"Rady Children\u2019s Hospital , San Diego, California , 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Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7337-2257","authenticated-orcid":false,"given":"Subra","family":"Kugathasan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Millie D","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shervin","family":"Rabizadeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cedars-Sinai Medical Center , Los Angeles, California , 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