P734 Should we have a higher threshold for anti-TNF serum levels in Crohn’s disease patients with perianal disease?
C. Arieira1,2,3, F. Dias de Castro1,2,3, T. Cúrdia Gonçalves1,2,3, M.J. Moreira1,2,3, J. Cotter1,2,3
1Hospital Senhora da Oliveira, Gastroenterology, Guimarães, Portugal, 2Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga/Guimarães, Portugal, 3ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Background
Tumour necrosis factor (TNF) inhibitors are potent drugs effective for the treatment of both luminal disease and perianal fistulas in Crohn’s disease (CD). Recently, there is some evidence that patients with perianal disease might need higher concentrations of anti-TNF levels compared with patients without perianal disease. The aim of this study was to compare anti-TNF serum concentrations: IFX (infliximab) or ADA (adalimumab) between patients with active and closed perianal fistulas with CD.
Methods
Retrospective study including that was on anti-TNF for at least 6 months. Fistula closure was defined as absence of active drainage at gentle finger compression and/or fistula healing on magnetic resonance imaging/ultrasound.
Results
We included 55 patients with CD and perianal disease, 54.5% males, median age of 31 (interquartile range: 18–71) years. Forty-two were on IFX and 13 on ADA. Median IFX serum concentrations [IQR] were higher in patients with closed fistulas (
Conclusion
Higher serum levels of anti-TNF drugs were associated with perianal fistula closure. Patients with CD and perianal disease may benefit from intensification of biological therapy.