Week 2 adalimumab levels predict clinical remission in IBD patients

Serum levels of adalimumab at week 2 is associated with short-term clinical remission in patients with inflammatory bowel disease (IBD), a study has shown.

This retrospective study included 46 consecutive IBD patients with a week 2 serum adalimumab level available. The authors performed a receiver operating characteristic curve analysis to determine an optimal week 2 threshold level for adalimumab.

Those above the threshold were compared for the primary outcome of week 12 clinical remission and the secondary outcome of short-term endoscopic healing. The association between week 2 adalimumab level and clinical remission was assessed through multivariate logistic regression analysis.

On receiver operating characteristic curve analysis, the optimal adalimumab level was 11.9 mcg/mL based on the area under the curve. Patients with week 2 adalimumab levels >11.9 mcg/mL were more likely to achieve clinical remission at week 12 compared to those with levels below or equal to the threshold (odds ratio, 3.34, 95 percent confidence interval, 1.01‒12.11; p=0.04).

Other covariates did not show a significant correlation with the primary outcome.

Furthermore, the rate of short-term endoscopic healing was numerically higher in patients with adalimumab week 2 levels >11.9 mcg/mL, but this did not reach statistical significance (71.4 percent vs 28.5 percent; p=0.11).

“Further research should explore whether patients with a week 2 adalimumab level equal to or below 11.9 mcg/mL benefit from early dose optimization,” the authors said.