Korean researchers said they confirmed a new therapeutic drug monitoring strategy to improve the treatment outcome in pediatric Crohn’s disease, a type of inflammatory bowel disease.
On Thursday, a research team of Professors Kim Mi-jin and Choe Yon-ho of pediatrics at Samsung Medical Center said they found the strategy to induce the optimal therapeutic effect by observing the concentration of adalimumab and ustekinumab and drug resistance during the treatment for Crohn’s diseases in children.
According to the research team, adalimumab and ustekinumab are considered innovative biologic agents for treating Crohn's disease. However, given the long-term treatment, the two drugs could cause severe adverse reactions such as inflammation or tumor. Thus, physicians should cautiously use them at the most appropriate concentration levels.
The research team conducted a prospective study on 31 patients and monitored the therapeutic drugs. The results showed that patients who reached clinical remission (CR) had a higher concentration of adalimumab in the blood (7.6±3.5 mg/ml) than those who did not (5.1±2.2 mg/ml).
Also, patients who achieved mucosal healing, an important indicator for successful treatment, had a higher concentration of adalimumab (14.2±7.6 mg/ml) than those who did not (7.8±5.2 mg/ml).
Based on the results, the research team concluded that adalimumab had to be at least 8.18 mg/ml in the blood to induce mucosal healing one year later and announced it as the standard for therapeutic drug monitoring.
The study was published in the Journal of Pediatric Gastroenterology and Nutrition last year.
Also, the research team conducted another study to establish the clinical standard for ustekinumab, which has been used to treat pediatric Crohn’s disease recently. The latest study was published in Therapeutic Drug Monitoring.
The research team analyzed blood samples from ustekinumab-treated patients and found that a low concentration of ustekinumab raised inflammation levels and worsened related clinical indicators.
“The two studies confirmed that therapeutic drug monitoring was the first step to achieve successful customized treatment,” the research team said. “We will continue our research to find the best method to boost therapeutic effects against Crohn’s disease and give new hope to pediatric Crohn’s disease patients.”