{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T23:28:21Z","timestamp":1791502101176,"version":"4.3.4"},"reference-count":40,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Introduction<\/jats:bold>\n                    : Ulcerative colitis (UC) is a chronic inflammatory disease that primarily affects the colon. Tumor necrosis factor-\u03b1 inhibitors (like adalimumab) are effective agents for UC. However, loss of response may occur. Proactive therapeutic drug monitoring involves measuring drug levels at regular intervals in patients in remission to maintain therapeutic concentrations and potentially prevent loss of response.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : This study aims to evaluate adalimumab trough level (TL), the development of anti-drug antibodies (ADAs), and their relationships with clinical and laboratory variables in Iraqi patients with ulcerative colitis receiving adalimumab therapy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients and methods<\/jats:bold>\n                    : The present study was cross-sectional and conducted from April 2024 to November 2024. It included 44 UC patients allocated into 2 groups: group 1 (patients with TL within or above the therapeutic range) and group 2 (patients with TL below the therapeutic range).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Out of 44 patients, 23 patients reached target TL, while 21 patients did not. Based on the TL, developments of ADAs, and clinical state of patients, recommendations were made to escalate the dose for 13 patients, switch therapy for 16 patients, de-escalate the dose for 10 patients, and continue therapy for 5 patients. Additionally, it was found that neutrophil count, erythrocyte sedimentation rate, and C-reactive protein were higher, and hemoglobin and packed cell volume were lower in patients who did not reach the target adalimumab TL (\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt;0.05).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Therapeutic drug monitoring for adalimumab can be an important tool for optimizing UC treatment and explaining the potential causes of non-responsiveness to this medicine.\n                  <\/jats:p>","DOI":"10.3897\/folmed.68.e170410","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:11:11Z","timestamp":1775218271000},"source":"Crossref","is-referenced-by-count":1,"title":["Therapeutic drug monitoring of adalimumab for dose optimization during maintenance therapy in patients with ulcerative colitis: real-world data"],"prefix":"10.3897","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2197-4952","authenticated-orcid":true,"given":"Ahmed","family":"Mansur Kadhim","sequence":"first","affiliation":[{"name":"Wasit Health Directorate, Ministry of Health, Baghdad, Iraq"},{"name":"College of Pharmacy, University of Baghdad, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-1441","authenticated-orcid":true,"given":"Dheyaa","family":"Jabbar Kadhim","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Baghdad, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3436-7105","authenticated-orcid":true,"given":"Raghad","family":"Jawad Hussein","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Teaching Hospital, Medical City, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"170410_B1","doi-asserted-by":"crossref","unstructured":"Fadhil AH, Kadhim HS, Hussain RJ, et al. The possible role of HCMV in inflammatory bowel diseases in sample of Iraqi patients. Iraqi J Med Sci 2019; 17(4):207\u201314.","DOI":"10.22578\/IJMS.17.3-4.7"},{"key":"170410_B2","doi-asserted-by":"crossref","unstructured":"Al-Abassi HM, Nazal MF, Ad\u2019hiah AH, et al. Serum profile of cytokines in Iraqi inflammatory bowel disease patients. Mustansiriya Med J 2015; 14(2):11\u201316.","DOI":"10.4103\/2070-1128.247848"},{"key":"170410_B3"},{"key":"170410_B4"},{"key":"170410_B5"},{"key":"170410_B6"},{"key":"170410_B7","unstructured":"Mohammed AK, Al-Qadhi HI, Alkhalidi NM, et al. Effectiveness of infliximab and adalimumab on Iraqi patients with ulcerative colitis \u2013real-world data. J Adv Pharm Edu Res 2020; 10(2):46\u201351."},{"key":"170410_B8"},{"key":"170410_B9"},{"key":"170410_B10"},{"key":"170410_B11"},{"key":"170410_B12"},{"key":"170410_B13"},{"key":"170410_B14"},{"key":"170410_B15"},{"key":"170410_B16"},{"key":"170410_B17","unstructured":"Vande Casteele N, Gils A, Papamichael K. Practical use of therapeutic drug monitoring of anti-TNF therapy in IBD. Pract Gastroenterol 2017; 41(1):11\u201318."},{"key":"170410_B18"},{"key":"170410_B19"},{"key":"170410_B20"},{"key":"170410_B21"},{"key":"170410_B22","unstructured":"The Italian Group. The Italian Group for study of Inflammatory Bowel Disease. [Info MAYO Partial]. [Cited 23\/7\/2025]. Available from: https:\/\/www.igibdscores.it\/en\/info-mayo-partial.php"},{"key":"170410_B23","unstructured":"Matriks Biotek. Shikari\u00ae (QS-ADA) Adalimumab ELISA Kit, Cat: ADA-SPEC-ADA. G\u00f6lba\u015f\u0131\/Ankara, Turkey: Matriks Biotek; 2025 [updated 2025 Feb. 18; cited 2025 Aug 8]. Available from: Shikari\u00ae (QS-ADA) Adalimumab ELISA (mAb-based) - Matriks Biotek"},{"key":"170410_B24","unstructured":"Matriks Biotek. Shikari\u00ae (S-ATA) Anti-Adalimumab ELISA w\/confirmation, Cat: ADA-QNS-HUM. G\u00f6lba\u015f\u0131\/Ankara, Turkey: Matriks Biotek; 2024 [updated 2024 Mar. 21; cited 2025 Aug 8]. Available from: https:\/\/ matriksbiotek.com\/products\/185\/shikari-s-ata-anti-adalimumab-elisa-w-confirmation"},{"key":"170410_B25","unstructured":"Fine Test Biotech. Human Calprotectin (CALP) ELISA Kit, Catalog Number: EH4140. Wuhan, China: Fine Test Biotech; 2023 [cited 2025 Aug 8]. Available from: https:\/\/www.fn-test.com\/product\/eh4140"},{"key":"170410_B26"},{"key":"170410_B27"},{"key":"170410_B28"},{"key":"170410_B29"},{"key":"170410_B30"},{"key":"170410_B31"},{"key":"170410_B32"},{"key":"170410_B33"},{"key":"170410_B34"},{"key":"170410_B35"},{"key":"170410_B36"},{"key":"170410_B37"},{"key":"170410_B38"},{"key":"170410_B39"},{"key":"170410_B40","doi-asserted-by":"crossref","unstructured":"Saleh HH, Kadhim DJ, Raghad JH. Correlation between therapeutic drug monitoring of infliximab serum trough levels. Al-Rafidain J Med Sci 2024; 6(1):239\u201345. Available from: https:\/\/ajms.iq\/index.php\/ALRAFIDAIN\/article\/view\/606","DOI":"10.54133\/ajms.v6i1.606"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/170410\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/170410\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=170410&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:11:12Z","timestamp":1775218272000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/170410\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,3]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.68.e170410","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,3]]},"article-number":"e170410"}}