Crohn's disease (CD) is a chronic inflammatory bowel disease that can result in progressive intestinal damage and disability, affecting mainly the ileal and ileocecal regions. CD can affect individuals of all ages, directly impacting the quality of life. Due to the absence of curative therapy, the current therapeutic objective is to obtain endoscopic and clinical remission, avoiding complications and future surgeries. TNF-alfa has been described as the main maintainer of the intestinal inflammatory state. The therapeutic use of monoclonal antibodies (MAbs), such as Adalimumab, proved to be a potent anti-inflammatory agent with fast action by binding to the TNF-alfa, neutralizing its function. Patients using MAbs may experience induction of anti-drug antibodies (ADA), leading to treatment failure and exacerbation of the disease. Thus, therapeutic optimization, based on the serum dosage of MAbs and measurement of the levels of ADA antibodies, has proved to be relevant. The present study aims to quantify the serum levels of Adalimumab and the levels of anti-Adalimumab antibodies in patients with CD of the Clinical Hospital from the University of Campinas (Unicamp). These analyses may elucidate one of the possible mechanisms acting on therapeutic failure, in addition to being used as a basis for therapeutic drug monitoring to maximize endoscopic response and to minimize side effects.
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