{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T20:30:16Z","timestamp":1782851416084,"version":"3.54.5"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We postulated that adalimumab [ADA] drug clearance [CL] may be a more critical determinant of therapeutic outcome than ADA concentration. This was tested in Crohn\u2019s disease [CD] patients undergoing ADA maintenance treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>CD patients from four cohorts received ADA induction and started maintenance therapy. Therapeutic outcomes consisted of endoscopic remission [ER], sustained C-reactive protein [CRP] based clinical remission [defined as CRP levels below 3 mg\/L in the absence of symptoms], and faecal calprotectin [FC] level below 100 \u00b5g\/g. Serum albumin, ADA concentration, and anti-drug antibody status were determined using immunochemistry and homogeneous mobility shift assay, respectively. CL was determined using a nonlinear mixed effect model with Bayesian priors. Statistical analysis consisted of Mann\u2013Whitney test and logistic regression with calculation of odds ratio. Repeated event analysis was conducted using a nonlinear mixed effect model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 237 enrolled patients [median age 40 years, 45% females], median CL was lower in patients achieving ER as compared with those with persistent active endoscopic disease [median 0.247 L\/day vs 0.326 L\/day, respectively] [p\u2005&amp;lt;0.01]. There was no significant difference in ADA concentration between patients in endoscopic remission compared with those with recurrence [median 9.3 \u00b5g\/mL vs 11.7 \u00b5g\/mL, respectively]. Sustained CRP-based clinical remission and FC levels below 100 \u00b5g\/g were generally associated with lower CL and higher ADA concentration. Repeated event analysis confirmed those findings with better performances of CL than concentration in associating with ER and other outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Lower ADA clearance is associated with an improved clinical outcome for patients with Crohn\u2019s disease and may be a superior pharmacokinetic measure than concentration.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjad140","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T14:29:38Z","timestamp":1692368978000},"page":"212-222","source":"Crossref","is-referenced-by-count":17,"title":["Adalimumab Clearance, Rather Than Trough Level, May Have Greatest Relevance to Crohn\u2019s Disease Therapeutic Outcomes Assessed Clinically and Endoscopically"],"prefix":"10.1093","volume":"18","author":[{"given":"Emily K","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, St Vincent\u2019s Hospital , Melbourne, VIC , Australia"},{"name":"Department of Gastroenterology, University of Melbourne , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-4242","authenticated-orcid":false,"given":"Maria","family":"Chaparro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario de La Princesa, IIS-Princesa, UAM and CIBEREHD , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gionchetti","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, IBD Unit IRCCS Azienda Ospedaliera Universitaria di Bologna and DIMEC University of Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1627-2057","authenticated-orcid":false,"given":"Amy L","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St Vincent\u2019s Hospital , Melbourne, VIC , Australia"},{"name":"Department of Gastroenterology, University of Melbourne , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Schulberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St Vincent\u2019s Hospital , Melbourne, VIC , Australia"},{"name":"Department of Gastroenterology, University of Melbourne , Melbourne, VIC , Australia"},{"name":"Department of Gastroenterology, Austin Health , Melbourne, VIC , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2090-3445","authenticated-orcid":false,"given":"Javier P","family":"Gisbert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario de La Princesa, IIS-Princesa, UAM and CIBEREHD , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chiara Valerii","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, IBD Unit IRCCS Azienda Ospedaliera Universitaria di Bologna and DIMEC University of Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Rizzello","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, IBD Unit IRCCS Azienda Ospedaliera Universitaria di Bologna and DIMEC University of Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"De Cruz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University of Melbourne , Melbourne, VIC , 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