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Original Articles

IBD

Long-term clinical and real-world experience with Crohn’s disease treated with anti-tumor necrosis factor-α antibodies: Haruka Otake, Satohiro Matsumoto, Hirosato Mashima; Intest Res 2022;20(4):464-474. Published online March 31, 2022; DOI: https://doi.org/10.5217/ir.2021.00139

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Background/Aims
Although anti-tumor necrosis factor (TNF)-α agents are important therapeutic drugs for Crohn’s disease (CD), data regarding their long-term sustained effects are limited. Herein, we evaluated the long-term loss of response (LOR) to anti-TNF-α agents in patients with CD.
Methods
This retrospective study included patients with CD who started treatment with infliximab or adalimumab as a first-line therapeutic approach. The cumulative event-free, retention, and surgery-free rates after the start of biological therapy were analyzed. Secondary LOR was analyzed in patients who achieved corticosteroid-free clinical remission after the start of biological therapy. Cox proportional hazards models were used to analyze the predictive factors of secondary LOR.
Results
The cumulative event-free rates at 1, 2, 5, and 10 years were 83.3%, 75.1%, 37.4%, and 23.3%, respectively. The incidence of LOR was 10.6% per patient-year of follow-up. At 12–14 weeks after the start of biological therapy, the proportion of patients with a C-reactive protein to albumin (CRP/ALB) ratio ≥0.18 was significantly higher in patients with LOR (P<0.001). Multivariate analysis indicates that a CRP/ALB ratio ≥0.18 (hazard ratio [HR], 5.86; 95% confidence interval [CI], 1.56–22.0; P=0.009) and upper gastrointestinal tract inflammation (HR, 3.00; 95% CI, 1.26–7.13; P=0.013) were predictive factors of secondary LOR.
Conclusions
Although anti-TNF-α agents contributed to long-term clinical remission of CD, the annual incidence of secondary LOR was 10.6%. The CRP/ALB ratio at 3 months after the start of biological therapy and upper gastrointestinal tract inflammation were identified as predictive factors of secondary LOR.

Citations

Citations to this article as recorded by

Serum biomarkers for predicting Crohn’s disease activity: The role of bilirubin, uric acid, and the C-reactive protein/albumin ratio
Ting Xu, Tingting Yao, Yating Chen, Fan Xu, Chunxia Lu, Aleksandra Klisic
PLOS One.2026; 21(3): e0333855. CrossRef
First-Line Guselkumab Combined with Exclusive Enteral Nutrition in Biologic-Naïve Young‑Onset Crohn’s Disease: A Three-Case Series from China
Sumei Sha, Bin Xu, Chenyang Qiao, Kairuo Wang, Le Liu, Jie Wu, Wenqi Ma, Ameng Shi, Xin Liu
Journal of Inflammation Research.2026; Volume 19: 1. CrossRef
Risk of Spondyloarthritis in Patients With Inflammatory Bowel Disease Receiving Treatment With Biologics or Janus Kinase Inhibitors
Young-Eun Kim, Soo Min Ahn, Ji Seon Oh, Yong-Gil Kim, Chang-Keun Lee, Bin Yoo, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park, Seokchan Hong
The Journal of Rheumatology.2026; 53(3): 260. CrossRef
Developing a Machine-Learning Prediction Model for Infliximab Response in Crohn’s Disease: Integrating Clinical Characteristics and Longitudinal Laboratory Trends
Yun Qiu, Shixian Hu, Kang Chao, Lingjie Huang, Zicheng Huang, Ren Mao, Fengyuan Su, Chuhan Zhang, Xiaoqing Lin, Qian Cao, Xiang Gao, Minhu Chen
Inflammatory Bowel Diseases.2025; 31(5): 1334. CrossRef
Comparative efficacy of subcutaneous infliximab switching in remission and non-remission patients with inflammatory bowel disease after intravenous maintenance: 1-year outcome from a multicentre cohort study
June Hwa Bae, Yoo Jin Lee, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Kyeong Ok Kim, Byung Ik Jang, Eun Soo Kim, Hyeong Ho Jo, Eun Young Kim, Sung Wook Hwan
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
The position of anti-tumor necrosis factor agents for the treatment of adult patients with Crohn’s disease
Stephen B. Hanauer, Byong Duk Ye, Raymond K. Cross, Silvio Danese, Geert D’Haens, Jinah Jung
Expert Review of Gastroenterology & Hepatology.2025; 19(7): 725. CrossRef
Therapeutic regimen of Crohn’s disease: effect of Infliximab combined with mesalazine on intestinal flora and inflammatory indexes in patients
Xiaoxia Xiang, Zhenghua Hu, Siyuan Dong, Bo Qi, Angyan Li, Liping Ji
BMC Gastroenterology.2025;[Epub] CrossRef
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Effectiveness and Tolerability of Methotrexate Combined with Biologics in Patients with Crohn’s Disease: A Multicenter Observational Study
Jihye Park, Jaeyoung Chun, Soo Jung Park, Jae Jun Park, Tae Il Kim, Hyuk Yoon, Jae Hee Cheon
Digestive Diseases and Sciences.2024; 69(3): 901. CrossRef
Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef
Comparative real-world outcomes between ustekinumab, infliximab, and adalimumab in bio-naïve and bio-experienced Crohn’s disease patients: a retrospective multicenter study
Ji Eun Na, Yong Eun Park, Jongha Park, Tae-Oh Kim, Jong Hoon Lee, Su Bum Park, Soyoung Kim, Seung Bum Lee
BMC Gastroenterology.2024;[Epub] CrossRef
Usefulness of Serum Leucine-rich Alpha 2 Glycoprotein in Crohn’s Disease: Is There Any Difference between Small Intestine and Colonic Lesions?
Satohiro Matsumoto, Hirosato Mashima
Crohn's & Colitis 360.2023;[Epub] CrossRef
Enrichment of Activated Fibroblasts as a Potential Biomarker for a Non-Durable Response to Anti-Tumor Necrosis Factor Therapy in Patients with Crohn’s Disease
Soo-Kyung Park, Gi-Young Lee, Sangsoo Kim, Chil-Woo Lee, Chang-Hwan Choi, Sang-Bum Kang, Tae-Oh Kim, Jaeyoung Chun, Jae-Myung Cha, Jong-Pil Im, Kwang-Sung Ahn, Seon-Young Kim, Min-Suk Kim, Chang-Kyun Lee, Dong-Il Park
International Journal of Molecular Sciences.2023; 24(19): 14799. CrossRef

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471 Download
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13 Crossref

IBD

Trough level of infliximab is useful for assessing mucosal healing in Crohn's disease: a prospective cohort study: Akihiro Koga, Toshiyuki Matsui, Noritaka Takatsu, Yasumichi Takada, Masahiro Kishi, Yutaka Yano, Takahiro Beppu, Yoichiro Ono, Kazeo Ninomiya, Fumihito Hirai, Takashi Nagahama, Takashi Hisabe, Yasuhiro Takaki, Kenshi Yao, Hirotsugu Imaeda, Akira Andoh; Intest Res 2018;16(2):223-232. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.223

Abstract PDF Supplementary Material PubReader ePub

<b>Background/Aims</b><br/>

Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2).

Methods

Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically.

Results

In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032).

Conclusions

TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.

Citations

Citations to this article as recorded by

Mucosal and Transmural Healing and Long-term Outcomes in Crohn’s Disease
Bruce E Sands, Silvio Danese, J Casey Chapman, Khushboo Gurjar, Stacy Grieve, Deepika Thakur, Jenny Griffith, Namita Joshi, Kristina Kligys, Axel Dignass
Inflammatory Bowel Diseases.2025; 31(3): 857. CrossRef
Is infliximab therapy currently relevant in patients with inflammatory bowel diseases? (review)
T. L. Alexandrov, B. A. Vykova
Koloproktologia.2024; 23(2): 173. CrossRef
Expression of inflammatory mediators in biofilm samples and clinical association in inflammatory bowel disease patients—a preliminary study
Mayte Buchbender, Jakob Fehlhofer, Peter Proff, Tobias Möst, Jutta Ries, Matthias Hannig, Markus F. Neurath, Madline Gund, Raja Atreya, Marco Kesting
Clinical Oral Investigations.2022; 26(2): 1217. CrossRef
Microbiota and Drug Response in Inflammatory Bowel Disease
Martina Franzin, Katja Stefančič, Marianna Lucafò, Giuliana Decorti, Gabriele Stocco
Pathogens.2021; 10(2): 211. CrossRef
Post-Induction High Adalimumab Drug Levels Predict Biological Remission at Week 24 in Patients With Crohn's Disease
Eran Zittan, A. Hillary Steinhart, Pavel Goldstein, Raquel Milgrom, Ian M. Gralnek, Mark S. Silverberg
Clinical and Translational Gastroenterology.2021; 12(10): e00401. CrossRef
Potential Utility of Therapeutic Drug Monitoring of Adalimumab in Predicting Short-Term Mucosal Healing and Histologic Remission in Pediatric Crohn's Disease Patients
So Yoon Choi, Young Ok Choi, Yon Ho Choe, Ben Kang
Journal of Korean Medical Science.2020;[Epub] CrossRef
Clinical and laboratory markers associated with anti-TNF-alpha trough levels and anti-drug antibodies in patients with inflammatory bowel diseases
Ana B. Grinman, Maria das Graças C. de Souza, Eliete Bouskela, Ana Teresa P. Carvalho, Heitor S. P. de Souza
Medicine.2020; 99(10): e19359. CrossRef
Changes in the Intestinal Microbiota of Patients with Inflammatory Bowel Disease with Clinical Remission during an 8-Week Infliximab Infusion Cycle
Gyeol Seong, Namil Kim, Je-Gun Joung, Eun Ran Kim, Dong Kyung Chang, Jongsik Chun, Sung Noh Hong, Young-Ho Kim
Microorganisms.2020; 8(6): 874. CrossRef
Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events
Mitchell R. K. L. Lie, Emma Paulides, C. Janneke van der Woude
International Journal of Colorectal Disease.2020; 35(8): 1489. CrossRef
Association of Infliximab Levels With Mucosal Healing Is Time-Dependent in Crohn’s Disease: Higher Drug Exposure Is Required Postinduction Than During Maintenance Treatment
Ting Feng, Baili Chen, Bella Ungar, Yun Qiu, Shenghong Zhang, Jinshen He, Sinan Lin, Yao He, Zhirong Zeng, Shomron Ben-Horin, Minhu Chen, Ren Mao
Inflammatory Bowel Diseases.2019; 25(11): 1813. CrossRef
Mucosal healing in inflammatory bowel disease: Expanding horizon
Jimil Shah, Manik Lal Thakur, Usha Dutta
Indian Journal of Gastroenterology.2019; 38(2): 98. CrossRef

9,993 View
79 Download
10 Web of Science
11 Crossref

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