{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:53:25Z","timestamp":1783475605128,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,3,1]],"date-time":"2020-03-01T00:00:00Z","timestamp":1583020800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the 7th Pinchas Borenstein Talpiot Medical Leadership Program, The Chaim Sheba Medical Center","award":["grant given to Dr Bella Ungar"],"award-info":[{"award-number":["grant given to Dr Bella Ungar"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In Crohn's disease, higher adalimumab trough levels and negative anti\u2010adalimumab\u2010antibodies associate with better clinical and endoscopic outcomes. Intestinal ultrasound has become a relevant non\u2010invasive method to monitor treatment. However, data on the association between adalimumab levels and bowel wall thickness measured with ultrasound is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to examine the possible association between the sonographic transmural\u2010thickness and adalimumab trough levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational cohort study was conducted at Sheba Medical Center in 2014\u20132018. Crohn's disease patients on adalimumab maintenance therapy with intestinal ultrasound performed within &lt;30\u00a0days of trough level measurement were included. Associations between terminal ileum and colonic thickness, adalimumab levels and therapy retention were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty events of ultrasound with concomitant adalimumab trough level measurements in 44 Crohn's disease patients were included. Patients with trough level &lt;3\u2009\u03bcg\/ml had significantly higher bowel wall thickness, both for terminal ileum (<jats:italic>p<\/jats:italic> \u2009=\u20090.04) and colon (<jats:italic>p<\/jats:italic> \u2009=\u20090.02). Thirty\u2010two patients continued adalimumab therapy over one year. The adalimumab retention rate was higher among those with terminal ileum thickness &lt;4\u2009mm (<jats:italic>p<\/jats:italic> \u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lower adalimumab trough levels were associated with higher bowel wall thickness indicating poorer therapy outcome. Transmural thickness measurement with ultrasound may be a useful target for guiding biologic therapy in Crohn's disease.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640619878974","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T07:10:35Z","timestamp":1568877035000},"page":"167-174","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Lower adalimumab trough levels are associated with higher bowel wall thickness in Crohn's disease"],"prefix":"10.1002","volume":"8","author":[{"given":"Bella","family":"Ungar","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Sheba Medical Center Tel Hashomer Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohar","family":"Ben\u2010Shatach","sequence":"additional","affiliation":[{"name":"Department of 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