{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T16:54:27Z","timestamp":1781456067437,"version":"3.54.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thiopurines are associated with improved infliximab pharmacokinetics (PK), but their impact on adalimumab PK and immunogenicity is not well defined. This study examined associations between 6-thioguanine (6-TGN) levels and antibodies to adalimumab (ATA), adalimumab drug levels (ADL), and adalimumab clearance (CL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a large clinical laboratory database, we included adults with Crohn\u2019s disease or ulcerative colitis treated with thiopurines and adalimumab who had RBC 6-TGN and adalimumab concentrations measured within 30\u2009days. ATA, ADL, and CL were assessed using drug-tolerant assays and nonlinear mixed-effects modeling. A 6-TGN threshold of\u2009\u2265\u2009125\u2009pmol\/8\u2009\u00d7\u2009108 RBCs was used. Logistic regression was performed to calculate odds ratios (ORs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 1,194 specimens from 1,100 patients; ATA positivity was 3.7%. Compared with 6-TGN \u2265125\u2009pmol\/8\u2009\u00d7\u2009108 RBCs, lower 6-TGN was associated with higher odds of ATA formation (&amp;gt;1.7\u2009U\/mL; OR\u202f=\u202f2.55), lower odds of ADL \u226510\u202f\u00b5g\/mL (OR\u202f= 0.58), and lower odds of low CL (&amp;lt; 0.318\u202fL\/day; OR\u202f=\u202f0.55). Compared with every-other-week dosing, weekly dosing produced higher ADL (13.1 vs 8.9\u2009\u00b5g\/mL; p\u2009&amp;lt;\u20090.01) but also higher CL (0.425 vs 0.302\u2009L\/day; p\u2009&amp;lt;\u20090.01). Within each dosing interval, higher 6-TGN levels were associated with lower prevalence of ATA (p\u2009&amp;lt;\u20090.05) and a higher chance of achieving ADL \u226510\u2009\u00b5g\/mL (p\u2009&amp;lt;\u20090.01) and CL\u2009&amp;lt;\u20090.318\u2009L\/day (p\u2009&amp;lt;\u20090.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher 6-TGN levels are associated with reduced immunogenicity, higher adalimumab drug levels, and lower clearance. Thiopurine may enhance adalimumab PK and support more favorable therapeutic response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/crocol\/otag053","type":"journal-article","created":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T16:07:02Z","timestamp":1781453222000},"source":"Crossref","is-referenced-by-count":0,"title":["The Association Between 6-Thioguanine Nucleotide Levels, Adalimumab Exposure, Immune Response, and Drug Clearance"],"prefix":"10.1093","author":[{"given":"Andres","family":"Yarur","sequence":"first","affiliation":[{"name":"Cedars-Sinai Medical Center Division of Gastroenterology and Hepatology, , Los Angeles, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C","family":"Lo","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Medical Center Division of Gastroenterology and Hepatology, , Los Angeles, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bincy","family":"Abraham","sequence":"additional","affiliation":[{"name":"Houston Methodist Department of Medicine, , Houston, TX,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Hanauer","sequence":"additional","affiliation":[{"name":"Northwestern University, Feinberg School of Medicine Division of Gastroenterology and Hepatology, Department of Medicine, , Chicago, IL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Dervieux","sequence":"additional","affiliation":[{"name":"Prometheus Laboratories , San Diego, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,13]]},"container-title":["Crohn's &amp; Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag053\/68522777\/otag053.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otag053\/68522777\/otag053.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T16:07:03Z","timestamp":1781453223000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article\/doi\/10.1093\/crocol\/otag053\/8707632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/crocol\/otag053","relation":{},"ISSN":["2631-827X"],"issn-type":[{"value":"2631-827X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"article-number":"otag053"}}