{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:13:26Z","timestamp":1772068406889,"version":"3.50.1"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> Low anti-tumor necrosis factor \u03b1 (TNF\u03b1) serum concentrations may result in lack of treatment response in patients with inflammatory bowel disease. We determined the anti-TNF\u03b1 drug concentrations in patients with inflammatory bowel disease and investigated whether or not subtherapeutic drug concentrations were associated with increased levels of disease activity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> In a single-center cross-sectional study, we included patients with ulcerative colitis or Crohn\u2019s disease who were receiving infliximab or adalimumab maintenance therapy. Demographic data, disease activity symptom scores (Partial Mayo Score, Harvey Bradshaw Index), inflammatory markers [C-reactive protein (CRP), fecal calprotectin], antidrug antibodies and serum drug concentrations were recorded. Therapeutic drug concentrations were defined as 3\u20138 mg\/liter for infliximab and 5\u201312 mg\/liter for adalimumab. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Of 210 patients included, 137 (65.2%) had Crohn\u2019s disease. In the adalimumab group, subtherapeutic drug concentrations were measured in 16.7% of patients with ulcerative colitis and in 27.7% of patients with Crohn\u2019s disease. In the infliximab group, subtherapeutic drug concentrations were found in 23% (ulcerative colitis) and 30.3% (Crohn\u2019s disease) of patients. In Crohn\u2019s disease, subtherapeutic adalimumab concentrations were associated with higher fecal calprotectin and CRP concentrations compared with therapeutic concentrations. Subtherapeutic infliximab concentrations in patients with Crohn\u2019s disease were also associated with higher CRP concentrations compared with therapeutic concentrations. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The prevalence of subtherapeutic drug levels ranged from 17% to 30%. In patients with Crohn\u2019s disease, subtherapeutic serum drug concentrations were associated with significantly higher disease activity with both anti-TNF\u03b1 agents. These findings were not observed in patients with ulcerative colitis. Clinicaltrials.gov identifier [NCT02134054] <\/jats:p><\/jats:sec>","DOI":"10.1177\/1756284818759930","type":"journal-article","created":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T09:11:03Z","timestamp":1521018663000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Subtherapeutic concentrations of infliximab and adalimumab are associated with increased disease activity in Crohn\u2019s disease"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-6394","authenticated-orcid":false,"given":"Arne","family":"Carlsen","sequence":"first","affiliation":[{"name":"Stavanger University Hospital, PO Box 8100, 4068 Stavanger, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roald","family":"Omdal","sequence":"additional","affiliation":[{"name":"Unit of Clinical Immunology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian \u00d8greid","family":"Leitao","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjetil","family":"Isaksen","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Kristine","family":"Hetta","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology, Department of Medicine, Stavanger University Hospital, Stavanger, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Normann","family":"Karlsen","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology, Department of Medicine, Stavanger University Hospital, Stavanger, 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