ArticleInflammatory bowel diseases2021
Favorable Outcomes and Anti-TNF Durability After Addition of an Immunomodulator for Anti-Drug Antibodies in Pediatric IBD Patients.
Article in Inflammatory bowel diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Reactive Immunomodulator Addition to Infliximab Monotherapy Restores Clinical Response in Inflammatory Bowel Disease: A Meta-Analysis.Digestive diseases and sciences · 2024Pooled it
- Is Routine Monitoring of TNF-α Inhibitor Levels and Antibodies in Pediatric IBD Justified in the Era of Personalized Medicine.Journal of clinical medicine · 2026Review
- Interaction of Clinical Factors Modestly Predict Anti-TNF-Alpha Antibody Formation in a Real-World Cohort of Inflammatory Bowel Disease Patients.Biomedicines · 2025Article
- Considerations in Paediatric and Adolescent Inflammatory Bowel Disease.Journal of Crohn's & colitis · 2024Review
- Infliximab Monotherapy vs Combination Therapy for Pediatric Crohn's Disease Exhibit Similar Pharmacokinetics.Inflammatory bowel diseases · 2024Article
- Successful multidisciplinary treatment of the rare pathology of vulvar Crohn's disease.BMJ case reports · 2023Article
- Efficacy of Combined Initial Treatment of Methotrexate with Infliximab in Pediatric Crohn's Disease: A Pilot Study.Biomedicines · 2023Article
- The Role of Therapeutic Drug Monitoring in Children.Gastroenterology clinics of North America · 2023Review
- Early Infliximab Clearance Predicts Remission in Children with Crohn's Disease.Digestive diseases and sciences · 2023Article
- Current Role of Monoclonal Antibody Therapy in Pediatric IBD: A Special Focus on Therapeutic Drug Monitoring and Treat-to-Target Strategies.Children (Basel, Switzerland) · 2023Review
- Immunomodulator comedication promotes the reversal of anti-drug antibody-mediated loss of response to anti-TNF therapy in inflammatory bowel disease.International journal of colorectal disease · 2023Article
- Past, Present and (Foreseeable) Future of Biological Anti-TNF Alpha Therapy.Journal of clinical medicine · 2023Review
- Antibodies-to-infliximab accelerate clearance while dose intensification reverses immunogenicity and recaptures clinical response in paediatric Crohn's disease.Alimentary pharmacology & therapeutics · 2022Article
- Corticosteroids Can Be Used to Decrease Antidrug Antibodies in Pediatric Patients With Inflammatory Bowel Disease.Inflammatory bowel diseases · 2021Article
- A Practical Guide to Therapeutic Drug Monitoring of Biologic Medications for Inflammatory Bowel Disease.Journal of clinical medicine · 2021Review
- The efficacy of immunomodulators in the prevention and suppression of anti-drug antibodies to anti-tumor necrosis factor therapy in inflammatory bowel disease.Annals of gastroenterologyReview
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAnti-drug antibodies (ADAs) to anti-tumor necrosis factor alpha (anti-TNF) drugs are associated with increased drug clearance and loss of response. We aimed to assess the effectiveness of starting an immunomodulator (IM) drug in patients with newly detected ADAs on anti-TNF monotherapy.
methodsWe reviewed the medical records of pediatric patients with inflammatory bowel disease on infliximab or adalimumab monotherapy with first-time detection of significant ADAs between 2014 and 2018. Patients who started an IM within 3 months of ADA detection were compared with those who did not (No-IM). Outcomes included steroid-free clinical and biochemical remission on the same anti-TNF , anti-TNF durability, and ADA reversal.
resultsWe identified 89 patients with ADAs: 30 IM patients and 59 No-IM patients. The initial anti-TNF was stopped shortly after ADA detection in 36% of the No-IM patients vs none of the IM patients, driving longer survival on the initial anti-TNF in the IM group (P = 0.005). At 12 months, steroid-free clinical and biochemical remission on the same anti-TNF occurred in 53.9% of the IM group vs 26.8% in the No-IM group (P = 0.025). Drug levels rose higher (P = 0.003) and ADA levels fell farther (P = 0.037) in the IM group than in the No-IM group. Baseline ADA level predicted ADA reversal in the No-IM patients with an area under the receiver operating characteristic of 0.79 (P = 0.006). An ADA level <329 ng/mL had a 76.2% sensitivity and an 83.3% specificity for ADA reversal without IM.
conclusionsPediatric patients with inflammatory bowel disease on anti-TNF monotherapy who started an IM for significant ADA levels exhibited longer anti-TNF durability and a higher likelihood of steroid-free clinical and biochemical remission on the same anti-TNF. Patients not treated with an IM were unlikely to reverse ADAs >329 ng/mL.
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