ArticleInternational journal of colorectal disease2023
Immunomodulator comedication promotes the reversal of anti-drug antibody-mediated loss of response to anti-TNF therapy in inflammatory bowel disease.
Article in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 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
- Anti-TNF immunogenicity in a Middle Eastern inflammatory bowel disease cohort: prevalence, predictors and context-specific drug level thresholds.BMJ open gastroenterology · 2026Article
- Successful methotrexate rescue following antibody-mediated infliximab failure for treatment-refractory hidradenitis suppurativa.JAAD case reports · 2026Article
- Trends in drug use and prescription patterns for Crohn's disease patients in China, 2018-2022.BMC health services research · 2026Article
- Immunogenicity phenotypes and reversal of pharmacokinetic impact in anti-TNF-treated immune-mediated diseases: a real-world study.International journal of clinical pharmacy · 2026Article
- Gradient Boosting Machine-Based Prognostic Model with SurvSHAP Analysis for Predicting Secondary Loss of Response to Infliximab Therapy in Crohn's Disease.Drug design, development and therapy · 2026Article
- Development and Validation of a Machine Learning Model to Predict Anti-Drug Antibody Formation During Infliximab Induction in Crohn's Disease.Biomedicines · 2025Article
- IQ Survey Results on Current Industry Practices: Part 2-Quantitative Evaluations of Immunogenicity Assessment.Clinical pharmacology and therapeutics · 2025Review
- Preventive Effect ofMolecules (Basel, Switzerland) · 2023Article
- A Review of Therapeutic Drug Monitoring in Patients with Inflammatory Bowel Disease Receiving Combination Therapy.Journal of clinical medicine · 2023Review
- The Role of Low-Dose Oral Methotrexate in Increasing Anti-TNF Drug Levels and Reducing Immunogenicity in IBD.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
purposeLoss of therapeutic response (LOR) due to anti-drug antibodies (ADA) against tumor necrosis factor (TNF) inhibitors is common in patients with inflammatory bowel disease (IBD). We aimed to investigate whether immunomodulator comedication can reverse the immunogenic LOR to TNF inhibitors in IBD.
methodsIn this real-world retrospective cohort study, 123 IBD patients with neutralizing ADA to infliximab or adalimumab and concomitant subtherapeutic trough levels were screened for clinical LOR. Subsequent ADA and trough level measurements and clinical outcomes were analyzed for patients who received either immunomodulator comedication or dose intensification of infliximab or adalimumab to overcome LOR.
resultsFollowing immunogenic LOR, the initial anti-TNF regimen was optimized in 33 patients. In univariable and multivariable logistic regression analyses, immunomodulator comedication was identified as the crucial factor for regaining clinical remission and ADA clearance. Detectable trough levels (≥ 0.98 or ≥ 1.00 mg/L, respectively) had optimal predictive performance for both endpoints in receiver operating characteristics curves [area under the curve 0.86 (95% confidence interval 0.68-1.00) for regaining clinical remission, 0.87 (0.71-1.00) for ADA clearance]. Furthermore, 11/20 patients (55%) on a comedication with azathioprine or methotrexate and 2/13 patients (15%) receiving anti-TNF dose intensification exclusively (P = 0.032) exhibited ADA elimination, regain of therapeutic trough levels, and clinical remission. Regain of clinical remission alone was achieved in 17/20 (85%) patients receiving comedication and 2/13 (15%) patients receiving anti-TNF dose intensification (P = 1.6 × 10
conclusionImmunogenic LOR to infliximab or adalimumab in IBD can be successfully reversed using immunomodulator comedication.
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Registered trials
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