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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2015

Open Access 01-12-2015 | Review

Optimizing biologic treatment in IBD: objective measures, but when, how and how often?

Authors: Shomron Ben-Horin, Ren Mao, Minhu Chen

Published in: BMC Gastroenterology | Issue 1/2015

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Abstract

Background

The advent of biologic agents for the treatment of inflammatory bowel disease (IBD) was accompanied in parallel with emerging understanding of persisting underlying inflammation and ensuing bowel damage that can occur even in patients with seeming clinical remission. This lead to the concepts of mucosal healing and deep remission gaining acceptance as the more desired goals for therapy within an ambitious disease-control therapeutic approach, namely, treat-to-target strategy. However, how to practically monitor IBD patients, which objective measures to follow, at what time-points and whether to act upon results in asymptomatic patients are all questions that remain disputed.

Methods and result

In this concise review we aim to provide an overview of objective measures for monitoring of IBD patients, focusing on the challenging group of patients treated by infliximab, adalimumab, vedolizumab and other biologics. These objective measures are discussed in the context of the different common clinical scenarios wherein the clinician may contemplate their use. Specifically, we will delineate the role of objective parameters to be monitored during induction phase of treatment, during maintenance therapy, at loss of response and after elective cessation of therapy in patients in remission.

Conclusion

Coupled with the non-negligible costs of therapy, and the over-all worse prognosis of moderate-severe patients who are the usual recipients of biologic therapies, this challenging patients seem to be the first candidates for this more proactive strategy combining inflammatory and pharmacokinetic monitoring of objective inflammatory and pharmacokinetic measures. More data is still desirable to better define the exact parameters to be followed and their optimal thresholds, and to delineate the optimal cost-effective interventions for these patients.
Literature
1.
Peters CP, Eshuis EJ, Toxopeüs FM, Hellemons ME, Jansen JM, D'Haens GR, et al. Adalimumab for Crohn's disease: long-term sustained benefit in a population-based cohort of 438 patients. J Crohn Colitis. 2014;8:866–77.CrossRef
2.
Reinisch W, Wang Y, Oddens BJ, Link R. C-reactive protein, an indicator for maintained response or remission to infliximab in patients with Crohn's disease: a post-hoc analysis from ACCENT I. Aliment Pharmacol Ther. 2012;35:568–76.PubMedCrossRef
3.
Jürgens M, Mahachie John JM, Cleynen I, Schnitzler F, Fidder H, van Moerkercke W, et al. Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn's disease. Clin Gastroenterol Hepatol. 2011;9(5):421–7.e1.PubMedCrossRef
4.
Arias MT, Vande Casteele N, Vermeire S, de Buck van Overstraeten A, Billiet T, Baert F, et al. A panel to predict long-term outcome of infliximab therapy for patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2015;13(3):531–8.PubMedCrossRef
5.
Monterubbianesi R, Aratari A, Armuzzi A, Daperno M, Biancone L, Cappello M, et al. Italian Group for the study of Inflammatory Bowel Disease (IG-IBD). J Crohns Colitis. 2014;8:852–8.PubMedCrossRef
6.
Magro F, Rodrigues-Pinto E, Santos-Antunes J, Vilas-Boas F, Lopes S, Nunes A, et al. High C-reactive protein in Crohn's disease patients predicts nonresponse to infliximab treatment. J Crohns Colitis. 2014;8(2):129–36.PubMedCrossRef
7.
Sandborn WJ, Colombel JF, D'Haens G, Plevy SE, Panés J, Robinson AM, et al. Association of baseline C-reactive protein and prior anti-tumor necrosis factor therapy with need for weekly dosing during maintenance therapy with adalimumab in patients with moderate to severe Crohn's disease. Curr Med Res Opin. 2013;29(5):483–93.PubMedCrossRef
8.
Gibson DJ, Heetun ZS, Redmond CE, Nanda KS, Keegan D, Byrne K, et al. An Accelerated Infliximab Induction Regimen Reduces the Need for Early Colectomy in Patients With Acute Severe Ulcerative Colitis. Clin Gastroenterol Hepatol. 2015;13(2):330–5.PubMedCrossRef
9.
Atreya R, Neumann H, Neufert C, Waldner MJ, Billmeier U, Zopf Y, et al. In vivo imaging using fluorescent antibodies to tumor necrosis factor predicts therapeutic response in Crohn's disease. Nat Med. 2014;20(3):313–8.PubMedCentralPubMedCrossRef
10.
Iwasa R, Yamada A, Sono K, Furukawa R, Takeuchi K, Suzuki Y. C-reactive protein level at 2 weeks following initiation of infliximab induction therapy predicts outcomes in patients with ulcerative colitis: a 3 year follow-up study. BMC Gastroenterol. 2015;15:103.PubMedCentralPubMedCrossRef
11.
Kobayashi T, Suzuki Y, Motoya S, Hirai F, Ogata H, Ito H, Sato N, Ozaki K, Watanabe M, Hibi T. First trough level of infliximab at week 2 predicts future outcomes of induction therapy in ulcerative colitis-results from a multicenter prospective randomized controlled trial and its post hoc analysis. J Gastroenterol. 2015 Jul 11. [Epub ahead of print]
12.
Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ, et al. Parikh A; GEMINI 1 Study Group. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2013;369(8):699–710.PubMedCrossRef
13.
Wyant T, Estevam J, Yang L, Rosario M. Development and validation of receptor occupancy pharmacodynamic assays used in the clinical development of the monoclonal antibody vedolizumab. Cytometry B Clin Cytom. 2015 Apr 23. doi: 10.​1002/​cyto.​b.​21236. [Epub ahead of print]
14.
Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE, et al. Vedolizumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2013;369(8):711–21.PubMedCrossRef
15.
Shelton E, Allegretti JR, Stevens B, Lucci M, Khalili H, Nguyen DD, et al. Efficacy of vedolizumab as induction therapy in refractory IBD patients: A multi-center cohort. Inflamm Bowel Dis Inflamm Bowel Dis. 2015 Aug 17. [Epub ahead of print]PMID: 26288002
16.
Paredes JM, Ripollés T, Cortés X,Martínez MJ, Barrachina M, Gómez F et al. Abdominal sonographic changes after antibody to tumor necrosis factor (anti-TNF) alpha therapy in Crohn's Disease. Dig Dis Sci. 2010;55(2):404–10.PubMedCrossRef
17.
Moreno N, Ripollés T, Paredes JM,Ortiz I, Martínez MJ, López A et al. Usefulness of abdominal ultrasonography in the analysis of endoscopic activity in patients with Crohn's disease: changes following treatment with immunomodulators and/or anti-TNF antibodies. J Crohns Colitis. 2014;8(9):1079–87.PubMedCrossRef
18.
Castiglione F, Testa A, Rea M, De Palma GD, Diaferia M, Musto D et al. Transmural healing evaluated by bowel sonography in patients with Crohn's disease on maintenance treatment with biologics. Inflamm Bowel Dis. 2013;19(9):1928–34.PubMed
19.
Mao R, Xiao YL, Gao X, Chen BL, He Y, Yang L et al. Fecal calprotectin in predicting relapse of inflammatory bowel diseases: a meta-analysis of prospective studies. Inflamm Bowel Dis. 2012;18(10):1894–9.PubMedCrossRef
20.
De Vos M, Louis EJ, Jahnsen J, Vandervoort JG, Noman M, Dewit O et al. Consecutive fecal calprotectin measurements to predict relapse in patients with ulcerative colitis receiving infliximab maintenance therapy. Inflamm Bowel Dis. 2013;19(10):2111–7.PubMedCrossRef
21.
Jauregui-Amezaga A, López-Cerón M, Aceituno M, Jimeno M, Rodríguez de Miguel C, Pinó-Donnay S et al. Accuracy of advanced endoscopy and fecal calprotectin for prediction of relapse in ulcerative colitis: a prospective study. Inflamm Bowel Dis. 2014;20(7):1187–93.PubMedCrossRef
22.
Yamada S, Yoshino T, Matsuura M, Minami N, Toyonaga T, Honzawa Y, et al. Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience. BMC Gastroenterol. 2014;14:80.PubMedCentralPubMedCrossRef
23.
Peyrin-Biroulet L, Reinisch W, Colombel JF, Mantzaris GJ, Kornbluth A, Diamond R, et al. Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn's disease in the SONIC trial. Gut. 2014;63(1):88–95.PubMedCrossRef
24.
Kopylov U, Yablecovitch D, Lahat A, Neuman S, Levhar N, Greener T, Klang E, Rozendorn N, Amitai MM, Ben-Horin S, Eliakim R. Detection of Small Bowel Mucosal Healing and Deep Remission in Patients With Known Small Bowel Crohn's Disease Using Biomarkers, Capsule Endoscopy, and Imaging. Am J Gastroenterol. 2015 Jul 28. doi: 10.​1038/​ajg.​2015.​221. [Epub ahead of print]
25.
Cornillie F, Hanauer SB, Diamond RH, Wang J, Tang KL, Xu Z, et al. Postinduction serum infliximab trough level and decrease of C-reactive protein level are associated with durable sustained response to infliximab: a retrospective analysis of the ACCENT I trial. Gut. 2014;63(11):1721–7.PubMedCentralPubMedCrossRef
26.
Molander P, af Björkesten CG, Mustonen H, Haapamäki J, Vauhkonen M, Kolho KL, et al. Fecal calprotectin concentration predicts outcome in inflammatory bowel disease after induction therapy with TNFα blocking agents. Inflamm Bowel Dis. 2012;18(11):2011–7.PubMedCrossRef
27.
Boschetti G, Garnero P, Moussata D, Cuerq C, Préaudat C, Duclaux-Loras R, et al. Accuracies of serum and fecal S100 proteins (calprotectin and calgranulin C) to predict the response to TNF antagonists in patients with Crohn's disease. Inflamm Bowel Dis. 2015;21(2):331–6.PubMedCrossRef
28.
Singh N, Rosenthal CJ, Melmed GY, Mirocha J, Farrior S, Callejas S, et al. Early infliximab trough levels are associated with persistent remission in pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis. 2014;20(10):1708–13.PubMedCrossRef
29.
Kiss LS, Szamosi T, Molnar T, Miheller P, Lakatos L, Vincze A, et al. Early clinical remission and normalisation of CRP are the strongest predictors of efficacy, mucosal healing and dose escalation during the first year of adalimumab therapy in Crohn's disease. Aliment Pharmacol Ther. 2011;34(8):911–22.PubMedCrossRef
30.
Laharie D, Mesli S, El Hajbi F, Chabrun E, Chanteloup E, Capdepont M, et al. Prediction of Crohn's disease relapse with faecal calprotectin in infliximab responders: a prospective study. Aliment Pharmacol Ther. 2011;34(4):462–9.PubMedCrossRef
31.
Adedokun OJ, Sandborn WJ, Feagan BG, Rutgeerts P, Xu Z, Marano CW, et al. Association between serum concentration of infliximab and efficacy in adult patients with ulcerative colitis. Gastroenterology. 2014;147(6):1296–307.PubMedCrossRef
32.
Roblin X, Marotte H, Leclerc M, Del Tedesco E, Phelip JM, Peyrin-Biroulet L, et al. Combination of C-reactive Protein, Infliximab Trough Levels, and Stable but Not Transient Antibodies to Infliximab Are Associated With Loss of Response to Infliximab in Inflammatory Bowel Disease. J Crohns Colitis. 2015;9(7):525–31.PubMedCrossRef
33.
Colombel JF, Sandborn WJ, Ghosh S, Wolf DC, Panaccione R, Feagan B, et al. Four-year maintenance treatment with adalimumab in patients with moderately to severely active ulcerative colitis: Data from ULTRA 1, 2, and 3. Am J Gastroenterol. 2014;109(11):1771–80.PubMedCentralPubMedCrossRef
34.
Ungar B, Chowers Y, Yavzori M, Picard O, Fudim E, Har-Noy O, et al. The temporal evolution of antidrug antibodies in patients with inflammatory bowel disease treated with infliximab. Gut. 2014;63:1258–64.PubMedCrossRef
35.
Baert F, Kondragunta V, Lockton S, Vande Casteele N, Hauenstein S, Singh S, Karmiris K, Ferrante M, Gils A, Vermeire S. Antibodies to adalimumab are associated with future inflammation in Crohn's patients receiving maintenance adalimumab therapy: a post hoc analysis of the Karmiris trial. Gut. 2015 Apr 10. doi: 10.​1136/​gutjnl-2014-307882. [Epub ahead of print]
36.
Vande Casteele N, Khanna R, Levesque BG, Stitt L, Zou GY, Singh S, Lockton S, Hauenstein S, Ohrmund L, Greenberg GR, Rutgeerts PJ, Gils A, Sandborn WJ,Vermeire S, Feagan BG. The relationship between infliximab concentrations, antibodies to infliximab and disease activity in Crohn's disease. Gut 2014 Oct 21. doi: 10.​1136/​gutjnl-2014-307883. [Epub ahead of print]. PMID: 25336114
37.
Kopylov U, Mazor Y, Yavzori M, Fudim E, Katz L, Coscas D, et al. Clinical utility of antihuman lambda chain-based enzyme-linked immunosorbent assay (ELISA) versus double antigen ELISA for the detection of anti-infliximab antibodies. Inflamm Bowel Dis. 2012;18:1628–33.PubMedCrossRef
38.
Vande Casteele N, Ferrante M, Van Assche G, Ballet V, Compernolle G, Van Steen K, et al. Trough concentrations of infliximab guide dosing for patients with inflammatory bowel disease. Gastroenterology. 2015;148(7):1320–9.PubMedCrossRef
39.
Osterman MT, Aberra FN, Cross R, Liakos S, McCabe R, Shafran I, et al. Mesalamine dose escalation reduces fecal calprotectin in patients with quiescent ulcerative colitis. Clin Gastroenterol Hepatol. 2014;12(11):1887–93.PubMedCentralPubMedCrossRef
40.
Lasson A, Öhman L, Stotzer PO, Isaksson S, Überbacher O, Ung KA, et al. Pharmacological intervention based on fecal calprotectin levels in patients with ulcerative colitis at high risk of a relapse: A prospective, randomized, controlled study. United European Gastroenterol J. 2015;3(1):72–9.PubMedCentralPubMedCrossRef
41.
Allez M, Karmiris K, Louis E, Van Assche G, Ben-Horin S, Klein A, et al. Report of the ECCO pathogenesis workshop on anti-TNF therapy failures in inflammatory bowel diseases: definitions, frequency and pharmacological aspects. J Crohns Colitis. 2010;4(4):355–66.PubMedCrossRef
42.
Afif W, Loftus Jr EV, Faubion WA, Kane SV, Bruining DH, Hanson KA, et al. Clinical utility of measuring infliximab and human anti-chimeric antibody concentrations in patients with inflammatory bowel disease. Am J Gastroenterol. 2010;105:1133–9.PubMedCrossRef
43.
Roblin X, Rinaudo M, Del Tedesco E, Phelip JM, Genin C, Peyrin-Biroulet L, et al. Development of an algorithm incorporating pharmacokinetics of adalimumab in inflammatory bowel diseases. Am J Gastroenterol. 2014;109:1250–6.PubMedCrossRef
44.
Yanai H, Lichtenstein L, Assa A, Mazor Y, Weiss B, Levine A, et al. Levels of drug and antidrug antibodies are associated with outcome of interventions after loss of response to infliximab or adalimumab. Clin Gastroenterol Hepatol. 2015;13:522–30.PubMedCrossRef
45.
Ben-Horin S, Waterman M, Kopylov U, Yavzori M, Picard O, Fudim E, et al. Addition of an immunomodulator to infliximab therapy eliminates antidrug antibodies in serum and restores clinical response of patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013;11(4):444–7.PubMedCrossRef
46.
Steenholdt C, Brynskov J, Thomsen OO, Munck LK, Fallingborg J, Christensen LA et al. Individualised therapy is more cost-effective than dose intensification in patients with Crohn's disease who lose response to anti-TNF treatment: a randomised, controlled trial. Gut. 2014;63:919–27.PubMedCrossRef
47.
Khanna R, Sattin BD, Afif W, Benchimol EI, Bernard EJ, Bitton A, et al. Review article: a clinician's guide for therapeutic drug monitoring of infliximab in inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38(5):447–59.PubMedCrossRef
48.
Ben-Horin S, Chowers Y. Tailoring anti-TNF therapy in IBD: drug levels and disease activity. Nat Rev Gastroenterol Hepatol. 2014;11(4):243–55.PubMedCrossRef
49.
Molander P, Färkkilä M, Salminen K, Kemppainen H, Blomster T, Koskela R, et al. Outcome after discontinuation of TNFα-blocking therapy in patients with inflammatory bowel disease in deep remission. Inflamm Bowel Dis. 2014;20(6):1021–8.PubMed
50.
Louis E, Mary JY, Vernier-Massouille G, Grimaud JC, Bouhnik Y, Laharie D et al. Maintenance of remission among patients with Crohn's disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology. 2012;142:63–70.PubMedCrossRef
51.
Ben-Horin S, Chowers Y, Ungar B, Kopylov U, Loebstein R, Weiss B, et al. Undetectable anti-TNF drug levels in patients with long-term remission predict successful drug withdrawal. Aliment Pharmacol Ther. 2015;42(3):356–64.PubMedCrossRef
52.
Colombel JF, Rutgeerts PJ, Sandborn WJ, Yang M, Camez A, Pollack PF, et al. Adalimumab induces deep remission in patients with Crohn's disease. Clin Gastroenterol Hepatol. 2014;12(3):414–22.PubMedCrossRef
53.
Frøslie KF, Jahnsen J, Moum BA, Vatn MH, IBSEN Group. Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology. 2007;133(2):412–22.PubMedCrossRef
54.
Laharie D, Filippi J, Roblin X, Nancey S, Chevaux JB, Hébuterne X, et al. Impact of mucosal healing on long-term outcomes in ulcerative colitis treated with infliximab: a multicenter experience. Aliment Pharmacol Ther. 2013;37(10):998–1004.PubMedCrossRef
55.
Colombel JF, Rutgeerts P, Reinisch W, Esser D, Wang Y, Lang Y, et al. Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis. Gastroenterology. 2011;141(4):1194–201.PubMedCrossRef
56.
Turner D, Griffiths AM, Veerman G, Johanns J, Damaraju L, Blank M, et al. Endoscopic and clinical variables that predict sustained remission in children with ulcerative colitis treated with infliximab. Clin Gastroenterol Hepatol. 2013;11(11):1460–5.PubMedCrossRef
57.
Roblin X, Marotte H, Rinaudo M, Del Tedesco E, Moreau A, Phelip JM, et al. Association between pharmacokinetics of adalimumab and mucosal healing in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2014;12(1):80–4.PubMedCrossRef
58.
Ungar B, Levy I, Yavne Y, Yavzori M, Picard O, Fudim E, Loebstein R, Chowers Y, Eliakim R, Kopylov U, Ben-Horin S. Optimizing anti-TNFα therapy: Serum Levels of Infliximab and Adalimumab Associate With Mucosal Healing in Patients with Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2015 Oct 29. doi: 10.​1016/​j.​cgh.​2015.​10.​025. [Epub ahead of print]
59.
De Cruz P, Kamm MA, Hamilton AL, Ritchie KJ, Krejany EO, Gorelik A et al. Crohn's disease management after intestinal resection: a randomised trial. Lancet. 2015;385:1406–17.PubMedCrossRef
60.
Iacucci M, Fort Gasia M, Hassan C, Panaccione R, Kaplan GG, Ghosh S, et al. Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings. Endoscopy. 2015;47(8):726–34.PubMedCrossRef
61.
Buda A, Hatem G, Neumann H, D'Incà R, Mescoli C, Piselli P, et al. Confocal laser endomicroscopy for prediction of disease relapse in ulcerative colitis: a pilot study. J Crohns Colitis. 2014;8(4):304–11.PubMedCrossRef
62.
D'Haens G, Ferrante M, Vermeire S, Baert F, Noman M, Moortgat L, et al. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflamm Bowel Dis. 2012;18(12):2218–24.PubMedCrossRef
63.
Mooiweer E, Severs M, Schipper ME, Fidder HH, Siersema PD, Laheij RJ, et al. Low fecal calprotectin predicts sustained clinical remission in inflammatory bowel disease patients: a plea for deep remission. J Crohns Colitis. 2015;9(1):50–5.PubMedCrossRef
Metadata
Title
Optimizing biologic treatment in IBD: objective measures, but when, how and how often?
Authors
Shomron Ben-Horin
Ren Mao
Minhu Chen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2015
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-015-0408-x

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