Journal of Gastroenterology

, Volume 49, Issue 1, pp 100–109 | Cite as

Clinical utility of newly developed immunoassays for serum concentrations of adalimumab and anti-adalimumab antibodies in patients with Crohn’s disease

  • Hirotsugu Imaeda
  • Kenichiro Takahashi
  • Takehide Fujimoto
  • Shigeki Bamba
  • Tomoyuki Tsujikawa
  • Masaya Sasaki
  • Yoshihide Fujiyama
  • Akira Andoh
Original Article—Alimentary Tract



The appearance of anti-adalimumab antibodies (AAAs) is associated with low serum adalimumab (ADA) trough levels and a decrease of clinical response. The goal of this study was to assess the accuracy and clinical utility of new immunoassays for serum ADA and AAA levels.

Patients and methods

Serum ADA trough levels and AAA levels were measured using new immunoassays in 40 patients with Crohn’s disease (CD) receiving ADA maintenance therapy.


Serum ADA trough levels were 12.3 ± 9.6 μg/ml (n = 40) in CD patients, and 14 of 40 patients (35 %) were positive for AAAs. A negative correlation was observed between serum AAA levels and ADA trough levels (y = −6.02x + 18.7, r = −0.54, P < 0.001, n = 40). The ROC (receiver-operator curve) analyses indicated that an ADA trough of 5.9 μg/ml was optimal to maintain negative CRP (C-reactive protein) levels (≤0.3 mg/dl). The ADA trough levels were significantly lower in patients positive for AAAs (5.5 ± 5.4 μg/ml, n = 14) than in patients negative for AAAs (16.0 ± 9.5 μg/ml, n = 26). The CRP and ESR levels were significantly higher in AAA-positive patients than in AAA-negative patients. Serum albumin levels were significantly lower in AAA-positive patients. The positive rate for AAAs in patients who lost a response to infliximab (50 %) was significantly higher than that of anti-TNF-α drug naïve patients (12.5 %).


These new assays for serum AAA trough and AAA levels are useful for routine clinical use and may help guide selection of optimal management strategies for IBD patients with a loss of response to ADA.


Infliximab Loss of response Anti-infliximab antibody 



This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (21590809) and by the Health and Labour Sciences Research Grants for Research on Intractable Diseases from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

The authors have declared that no conflict of interest exists.

Supplementary material

535_2013_803_MOESM1_ESM.pptx (102 kb)
Supplementary material 1 (PPTX 102 kb)


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hirotsugu Imaeda
    • 1
  • Kenichiro Takahashi
    • 2
  • Takehide Fujimoto
    • 2
  • Shigeki Bamba
    • 1
  • Tomoyuki Tsujikawa
    • 1
  • Masaya Sasaki
    • 1
  • Yoshihide Fujiyama
    • 1
  • Akira Andoh
    • 2
  1. 1.Department of MedicineShiga University of Medical ScienceOtsuJapan
  2. 2.Division of Mucosal Immunology, Graduate SchoolShiga University of Medical ScienceOtsuJapan

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