The association of tissue anti-TNF drug levels with serological and endoscopic disease activity in inflammatory bowel disease: the ATLAS study

Abstract

Our data suggest that local tissue inflammation characterised by high levels of TNF serves as a sink for anti-TNF. We further postulate that some patients with high serum anti-TNF levels have active disease because tissue levels of anti-TNF are insufficient to neutralise local TNF production.

Predicting durable response or resistance to antitumor necrosis factor therapy in inflammatory bowel disease

“…In a recent study comparing tissue levels of TNF alpha and anti-TNF antibodies in the mucosa of IBD patients, a significant correlation was observed between serum and the tissue levels in the noninflamed mucosa. However, in areas of active inflammation, the correlation was poor, and the ratio of TNF alpha to anti-TNF was skewed [Yarur et al 2015]. In a novel study by Atreya and colleagues that applied a fluorescent antimembrane-bound TNF (mTNF) antibody, CD patients with high numbers of mTNF(+) cells on confocal laser endomicroscopy showed significantly higher short-term response rates (92%) at week 12 upon subsequent anti-TNF therapy when compared with patients with low amounts of mTNF(+) cells (15%).…”

Positive relationship between infliximab and adalimumab trough levels at completion of induction therapy with clinical response rates, at a tertiary referral center

“…Antibody formation against anti‐TNFα can lead to reduced trough levels of anti‐TNFα, which can lead to increased disease activity 5. In addition, there is evidence particularly for acute severe ulcerative colitis (UC) that the inflamed, ulcerated gut can act as a sink for anti‐TNFα, with greater loss of anti‐TNFα in stool and subsequent suboptimal response 6, 7…”

Terapia de inducción acelerada con infliximab en paciente con colitis ulcerosa grave refractaria a corticoides. Caso clínico

“…Por ello, es importante considerar la presencia de factores que pueden modificar la farmacocinética de infliximab y con ello los niveles plasmáticos y tisulares del fármaco [17][18][19] . Niveles elevados de TNF-α a nivel plasmático y tisular, PCR elevada, hipoalbuminemia y un índice de masa corporal elevado, pueden aumentar el clearence de infliximab afectando de esta manera su efectividad.…”

“…demostraron recientemente que en pacientes con CUg, el grupo con falta de respuesta primaria no presentó niveles de infliximab menores que Terapia de inducción acelerada con infliximab en colitis ulcerosa severa -D. Fluxá et al el grupo que respondió a dosis estándar de infliximab 30 . Niveles de infliximab/TNF-α tisular o la pérdida de este fármaco por las deposiciones, deben ser considerados al evaluar la efectividad de esta terapia 19 . En nuestra paciente los niveles de infliximab y sus anticuerpos fueron medidos como parte de un protocolo de investigación antes de la 4a dosis (semana 12).…”