ArticleCrohn's & colitis 3602026
The association between 6-thioguanine nucleotide levels, adalimumab exposure, immune response, and drug clearance.
Article in Crohn's & colitis 360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Thiopurines are associated with improved infliximab pharmacokinetics (PK), but their impact on adalimumab PK and immunogenicity is not well defined. This study examined associations between 6-thioguanine (6-TGN) levels and antibodies to adalimumab (ATA), adalimumab drug levels (ADL), and adalimumab clearance (CL). Methods: Using a large clinical laboratory database, we included adults with Crohn's disease or ulcerative colitis treated with thiopurines and adalimumab who had RBC 6-TGN and adalimumab concentrations measured within 30 days. ATA, ADL, and CL were assessed using drug-tolerant assays and nonlinear mixed-effects modeling. A 6-TGN threshold of ≥125 pmol/8 × 10 Results: We analyzed 1194 specimens from 1100 patients; ATA positivity was 3.7%. Compared with 6-TGN ≥125 pmol/8 × 10 Conclusion: Higher 6-TGN levels are associated with reduced immunogenicity, higher adalimumab drug levels, and lower clearance. Thiopurine may enhance adalimumab PK and support a more favorable therapeutic response.
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