Evidence map›Paper›PMID 40321838›Full record

ArticleCrohn's & colitis 3602025

The Durability of Anti-TNF Therapy for Crohn's Disease Is Higher in Anti-TNF Naïve Patients and Increases With Proactive Therapeutic Drug Monitoring.

Robert Gilmore, Richard Fernandes, Tamar Schildkraut, Riddhi Joshi, Lyman Lin, Sara Vorgin, Amirah Etchegaray, Aathavan Shanmuga Anandan, George Tambakis, Moshe Loebenstein and 3 more

Abstract read
In one paragraph

Article in Crohn's & colitis 360, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Robert GilmoreDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.ORCID https://orcid.org/0000-0002-6648-658X
Richard FernandesDepartment of Gastroenterology, Mater Hospital, Brisbane, Australia.
Tamar SchildkrautDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Riddhi JoshiDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Lyman LinDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Sara VorginDepartment of Medicine, University of Melbourne, Melbourne, Australia.
Amirah EtchegarayDepartment of Gastroenterology, Mater Hospital, Brisbane, Australia.
Aathavan Shanmuga AnandanDepartment of Gastroenterology, Mater Hospital, Brisbane, Australia.ORCID https://orcid.org/0000-0002-5977-3978
George TambakisDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Moshe LoebensteinDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Yoon-Kyo AnDepartment of Gastroenterology, Mater Hospital, Brisbane, Australia.
Jakob BegunDepartment of Gastroenterology, Mater Hospital, Brisbane, Australia.ORCID https://orcid.org/0000-0001-5256-7672
Emily K WrightDepartment of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.ORCID https://orcid.org/0000-0003-3896-7826

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antitumor necrosis factor (TNF) dose escalation is performed to improve therapeutic response and optimize outcomes in patients with Crohn's disease (CD). We aimed to describe the durability of anti-TNF therapy in patients with CD receiving escalated anti-TNF therapy, along with the overall durability of anti-TNF treatment between patients managed with a proactive versus reactive therapeutic drug monitoring (TDM) approach. Methods: We undertook a retrospective multicentre cohort study. One center practiced proactive TDM with a weekly virtual TDM clinic, while the other practiced reactive TDM. Patients receiving escalated infliximab or adalimumab therapy for CD from January 2015 to April 2022 were included. Durability was defined as the time from biologic start to cessation for treatment failure. Results: About 239 patients (45% female, median age 39) meeting criteria for inclusion were identified. About 165 patients were included in the proactive TDM cohort and 74 in the reactive TDM cohort.Anti-TNF naïve patients had significantly higher durability of therapy when compared with the anti-TNF exposed patients for both overall durability ( Conclusions: This multicentre, retrospective cohort study illustrates the importance of dose escalation as a therapeutic strategy in IBD care. The durability of anti-TNF therapy is superior in anti-TNF naïve compared to exposed patients and can be improved further by proactive TDM to guide dose optimization.

Indexed as

adalimumabCrohn’s diseaseinfliximabproactivetherapeutic dose escalationtumor necrosis factor

Identifiers

PMID40321838
PMCPMC12048839

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.