Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study
Background: The emergence of tumor necrosis factor inhibitors (anti-TNF) has considerably changed the management of inflammatory bowel disease (IBD) in patients who do not respond to traditional therapies. This study assesses the prevalence of anti-TNF drug levels (DLs) and antibodies (ATAbs) in pat...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-03-01
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| Series: | The Saudi Journal of Gastroenterology |
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| Online Access: | https://journals.lww.com/10.4103/sjg.sjg_245_24 |
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| author | Ahmed Alghamdi Mohammed Alahmari Khulood Aljohani Aisha Alanazi Bashaar Al Ibrahim Mishal Alshowair Marwa Tawfik Waleed Alghamdi Salman Alanazi Faisal Alzayed Abdullah S Alghamdi Abdullah Bawazir Hussam Alhamidi |
| author_facet | Ahmed Alghamdi Mohammed Alahmari Khulood Aljohani Aisha Alanazi Bashaar Al Ibrahim Mishal Alshowair Marwa Tawfik Waleed Alghamdi Salman Alanazi Faisal Alzayed Abdullah S Alghamdi Abdullah Bawazir Hussam Alhamidi |
| author_sort | Ahmed Alghamdi |
| collection | DOAJ |
| description | Background:
The emergence of tumor necrosis factor inhibitors (anti-TNF) has considerably changed the management of inflammatory bowel disease (IBD) in patients who do not respond to traditional therapies. This study assesses the prevalence of anti-TNF drug levels (DLs) and antibodies (ATAbs) in patients with IBD in Saudi Arabia and explores their associations with IBD type and prior anti-TNF failure.
Methods:
This cross-sectional study included patients aged 14–75 years diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), treated with anti-TNF medications at King Fahad Medical City over January 2016 to December 2022. Data were analyzed using descriptive statistics, Mann–Whitney U test, Kruskal–Wallis test, Pearson’s Chi-squared test, and multinomial logistic regression.
Results:
Among 392 patients with IBD (median age, 31 years), 75.8% were diagnosed with CD and 24.2% with UC. Anti-TNF levels were subtherapeutic in 27.0% patients, therapeutic in 21.5%, and supratherapeutic in 51.5%. ATAbs were negative in 73.1% patients, weakly positive in 9.8%, and positive in 17.1%. Subtherapeutic anti-TNF levels were significantly associated with positive ATAbs (P < 0.001). Prior anti-TNF therapy failure was observed in 37.2% cases, with 15.3% showing immunogenicity. No significant demographic differences were noted across ATAbs groups.
Conclusion:
We highlight the prevalence of subtherapeutic and supratherapeutic anti-TNF levels among patients with IBD in Saudi Arabia and their association with ATAbs. The findings underscore the importance of monitoring anti-TNF DLs and ATAbs to optimize treatment outcomes in IBD management. Future research should focus on the longitudinal impact of these factors and explore genetic predictors of treatment response. |
| format | Article |
| id | doaj-art-1bafd3c1f8524f27a1a292c1a4f536f2 |
| institution | OA Journals |
| issn | 1319-3767 1998-4049 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj-art-1bafd3c1f8524f27a1a292c1a4f536f22025-08-20T02:16:02ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492025-03-01312829210.4103/sjg.sjg_245_24Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional studyAhmed AlghamdiMohammed AlahmariKhulood AljohaniAisha AlanaziBashaar Al IbrahimMishal AlshowairMarwa TawfikWaleed AlghamdiSalman AlanaziFaisal AlzayedAbdullah S AlghamdiAbdullah BawazirHussam AlhamidiBackground: The emergence of tumor necrosis factor inhibitors (anti-TNF) has considerably changed the management of inflammatory bowel disease (IBD) in patients who do not respond to traditional therapies. This study assesses the prevalence of anti-TNF drug levels (DLs) and antibodies (ATAbs) in patients with IBD in Saudi Arabia and explores their associations with IBD type and prior anti-TNF failure. Methods: This cross-sectional study included patients aged 14–75 years diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), treated with anti-TNF medications at King Fahad Medical City over January 2016 to December 2022. Data were analyzed using descriptive statistics, Mann–Whitney U test, Kruskal–Wallis test, Pearson’s Chi-squared test, and multinomial logistic regression. Results: Among 392 patients with IBD (median age, 31 years), 75.8% were diagnosed with CD and 24.2% with UC. Anti-TNF levels were subtherapeutic in 27.0% patients, therapeutic in 21.5%, and supratherapeutic in 51.5%. ATAbs were negative in 73.1% patients, weakly positive in 9.8%, and positive in 17.1%. Subtherapeutic anti-TNF levels were significantly associated with positive ATAbs (P < 0.001). Prior anti-TNF therapy failure was observed in 37.2% cases, with 15.3% showing immunogenicity. No significant demographic differences were noted across ATAbs groups. Conclusion: We highlight the prevalence of subtherapeutic and supratherapeutic anti-TNF levels among patients with IBD in Saudi Arabia and their association with ATAbs. The findings underscore the importance of monitoring anti-TNF DLs and ATAbs to optimize treatment outcomes in IBD management. Future research should focus on the longitudinal impact of these factors and explore genetic predictors of treatment response.https://journals.lww.com/10.4103/sjg.sjg_245_24anti-tnfantibody formationinflammatory bowel diseaseloss of responsesaudi arabia |
| spellingShingle | Ahmed Alghamdi Mohammed Alahmari Khulood Aljohani Aisha Alanazi Bashaar Al Ibrahim Mishal Alshowair Marwa Tawfik Waleed Alghamdi Salman Alanazi Faisal Alzayed Abdullah S Alghamdi Abdullah Bawazir Hussam Alhamidi Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study The Saudi Journal of Gastroenterology anti-tnf antibody formation inflammatory bowel disease loss of response saudi arabia |
| title | Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study |
| title_full | Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study |
| title_fullStr | Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study |
| title_full_unstemmed | Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study |
| title_short | Prevalence and clinical implications of anti-drug antibody formation and serum drug levels among patients with IBD receiving anti-TNF therapy: A cross-sectional study |
| title_sort | prevalence and clinical implications of anti drug antibody formation and serum drug levels among patients with ibd receiving anti tnf therapy a cross sectional study |
| topic | anti-tnf antibody formation inflammatory bowel disease loss of response saudi arabia |
| url | https://journals.lww.com/10.4103/sjg.sjg_245_24 |
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