CCFA: Updates in IBD Conference (part 1)

My notes from a recent Georgia Chapter of CCFA’s conference. There could be errors of omission, transcription and/or errors in context based on my understanding.

Adam Cheifetz, MD Harvard School of Medicine

Optimizing IBD Treatments

  • Earlier treatment with effective therapies
  • Utilizing therapeutic drug monitoring

Goals are clinical and endoscopic remission

  • Imaging if not visible on endoscopy
  • Biomarker remission -adjunctive goal
  • Symptoms and endoscopy do not have good correlation in Crohn’s disease
  • Endoscopic healing associated with better outcomes
  • Treatment –>assessment –> adjust treatment if goal is not met

Biologic Agents:

  • First agent works best; TNF-exposed patients do not respond as well as TNF-naive patients to subsequent biologic
  • High rate of secondary loss of response

Therapeutic Drug Monitoring:

  • Combination therapy in Sonic study was associated with higher infliximab levels. It appears that optimized monotherapy is as effective as combination therapy (Colombel study).
  • Fistula treatment requires higher biologic levels
  • Lower biologic drug levels associated with development of antidrug antibodies
  • Proactive monitoring –recommended
  • Both infliximab and adalimumab are frequently underdosed, especially in pediatrics –>another reason for proactive monitoring
  • If sicker patients, consider checking TDM at week 10; less sick patients, reasonable to consider TDM at week 14

Related blog posts:

Disclaimer: These blog posts are for educational purposes only. Specific dosing of medications/diets (along with potential adverse effects) should be confirmed by prescribing physician/nutritionist.  This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition.

6 thoughts on “CCFA: Updates in IBD Conference (part 1)

  1. Pingback: Here’s The Proof That Proactive Drug Monitoring Improves Outcomes in Children With Crohn’s Disease | gutsandgrowth

  2. Pingback: Genetic Risk for Failing Infliximab | gutsandgrowth

  3. Pingback: What Happens After The First Anti-TNF Agent Doesn’t Work? | gutsandgrowth

  4. Pingback: Proactive Therapeutic Drug Monitoring in Pediatric Crohn’s disease -Better Outcomes | gutsandgrowth

  5. Pingback: Real-World Experience with Proactive Therapeutic Drug Monitoring in Inflammatory Bowel Disease | gutsandgrowth

  6. Pingback: For the Next Insurance Appeal: Therapeutic Drug Monitoring in Adalimumab Treatment (Pediatrics) & Satire on Prior Authorizations | gutsandgrowth

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