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Point-of-Care Assays Could Be Useful for Therapeutic Drug Monitoring of IBD Patients in a Proactive Strategy with Adalimumab

Authors :
Yara Nasser
Xavier Roblin
Anne-Emmanuelle Berger
Stéphane Paul
Mohamad Cherry
Dominique Dutzer
Source :
Journal of Clinical Medicine, Volume 9, Issue 9, Journal of Clinical Medicine, Vol 9, Iss 2739, p 2739 (2020)
Publication Year :
2020
Publisher :
MDPI AG, 2020.

Abstract

The objective of the study was to evaluate whether Point-of-Care (POC) assays are equivalent to ELISAs for measuring residual trough levels of adalimumab (ADA) in a cohort of Inflammatory Bowel Disease (IBD) patients. ADA trough levels obtained by POC assays were used to optimize patients in daily clinical practice. Different assays (three ELISAs (Enzyme-Linked ImmunoSorbent Assay) from two different suppliers and two POC assays) were compared to measure ADA trough levels in a first cohort of 31 IBD patients. All assays revealed a high correlation within the assays, ranging from 0.86 to 0.99. Cut-off values were always higher with ELISAs than with POC assays. Then, a small prospective clinical study with a second cohort of 37 IBD patients was performed to compare POC assays and ELISAs for their ability to optimize patients on the basis of the measured ADA trough levels. The use of a POC assay to monitor ADA trough levels did not improve the follow-up of patients with loss of response, as they were always optimized whatever their ADA residual rate. For patients in clinical remission, a POC assay can be useful in some clinical situations to maintain or de-escalate ADA doses according to the measured trough levels. In conclusion, different assays for ADA monitoring are quite equivalent. A POC assay could be only useful for a proactive strategy for asymptomatic patients with a sub-therapeutic dose of ADA, but new therapeutic thresholds need to be identified.

Details

ISSN :
20770383
Volume :
9
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....9c64beb9d4f6d160d3d6797c24d9c449
Full Text :
https://doi.org/10.3390/jcm9092739