{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:40:21Z","timestamp":1778740821446,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,7]],"date-time":"2019-04-07T00:00:00Z","timestamp":1554595200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Therapeutic drug monitoring of anti\u2010tumour necrosis factor (TNF) drugs and anti\u2010drug antibodies (ADA) is now recommended in the treatment of inflammatory bowel disease. However, assay types and drug concentration thresholds are still debated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To correlate inflammatory bowel disease activity in a New Zealand cohort with trough concentrations of infliximab and adalimumab, and ADA using locally developed competitive\u2010binding enzyme\u2010linked immunosorbent assays (ELISA) to establish threshold concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with ulcerative colitis (UC) and Crohn disease (CD) from Christchurch and Dunedin on anti\u2010TNF drugs &gt;12 weeks were enrolled. Trough blood samples were assayed for drug and ADA concentrations. Other data included quality of life, blood count, C\u2010reactive protein, albumin, renal function and disease activity indices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 103 patients, 53 were on infliximab (36 CD, 15 UC and 2 unclassified) and 50 adalimumab (48 CD and 2 UC). Median (range) infliximab and adalimumab concentrations were 10.5 (0\u201341) and 9.61 mg\/L (0\u201330). CD remission, Crohn Disease Activity Index &lt;150, correlated with infliximab and adalimumab concentration in CD (infliximab, <jats:italic>P<\/jats:italic> = 0.03; adalimumab, <jats:italic>P<\/jats:italic> = 0.04), with too few UC patients for analysis. Receiver operator curve analysis suggested a threshold value of 5.1 mg\/L for distinguishing active disease from remission for infliximab and 7.3 mg\/L for adalimumab in CD. Of 13 patients with infliximab &lt;2 mg\/L, 10 were ADA positive by homogeneous mobility shift assay (HMSA), including five with neutralising antibodies using ELISA. Of six with adalimumab &lt;2 mg\/L, three were ADA positive using HMSA, including one with neutralising antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using the New Zealand ELISA assay, threshold concentrations of 5 mg\/L for infliximab and 7 mg\/L for adalimumab are suggested to aid dosing decisions, consistent with results internationally. Both neutralising (ELISA) and non\u2010neutralising ADA (HMSA) are associated with low drug concentrations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14064","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T02:34:59Z","timestamp":1533782099000},"page":"513-518","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infliximab and adalimumab concentrations and anti\u2010drug antibodies in inflammatory bowel disease control using New Zealand assays"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2944-8338","authenticated-orcid":false,"given":"Murray L.","family":"Barclay","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Christchurch Hospital  Christchurch New Zealand"},{"name":"Department of Clinical Pharmacology Christchurch Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shwan","family":"Karim","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther T. Johanna","family":"Helms","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula E.","family":"Keating","sequence":"additional","affiliation":[{"name":"Immunology, Canterbury Health Laboratories  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1329-367X","authenticated-orcid":false,"given":"Barry","family":"Hock","sequence":"additional","affiliation":[{"name":"Department of Haematology University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa K.","family":"Stamp","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago  Christchurch New Zealand"},{"name":"Gastroenterology Unit, Southern District Health Board Dunedin Hospital  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199710093371502"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.73"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.01.048"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S4512"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.01.035"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.11.041"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308099"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05057.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000394"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14368"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000229"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e31828d23c3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000156"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000553"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-305279"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.031"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1586\/17512433.2016.1133288"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.016"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.328"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.14064","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T12:40:48Z","timestamp":1694349648000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/imj.14064"],"URL":"https:\/\/doi.org\/10.1111\/imj.14064","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]},"assertion":[{"value":"2018-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}