BÜHLMANN highlights at ECCO 2021

The European Crohn’s and Colitis Organization (ECCO) meeting is one of the major congresses in the Inflammatory Bowel Disease (IBD) world. During this event, all the news in the IBD field are presented in different talks, presentations and posters. This year a main focus was on Therapeutic Drug Monitoring (TDM) as statements recommending TDM in IBD monitoring were added to the updated ECCO-WCPGHAN guidelines. This focus was confirmed by the number of posters presenting TDM data. In addition to TDM, remote monitoring was a key topic with the ongoing pandemic forcing new ways of patient care. Of the presented abstracts, several stand out as they are using IBDoc® or BÜHLMANN’s Quantum Blue® TDM portfolio, our rapid tests using lateral flow technology, able to deliver results in less than 15 minutes!

P229 – Standardization of Quantum Blue® Rapid TDM Assays with WHO International Standards for Adalimumab and Infliximab

Recently, the WHO introduced anti-TNF standards for adalimumab and infliximab. A WHO standardization, based on an international reference material, allows a solid traceability and standardization of measurements and improves comparability among different assays. As there has been an excellent agreement observed between the previous Quantum Blue® calibration and the WHO based calibration, the WHO standardization can now be successfully added to the methodical traceability of the quantitative Quantum Blue® Adalimumab and Quantum Blue® Infliximab lateral flow assays. The uncertainty observed was low with 0.32 mg/ml for infliximab and 0.35 mg/ml for adalimumab. According to the available information, the Quantum Blue® Adalimumab and Quantum Blue® Infliximab are the first commercially available quantitative lateral flow assays incorporating a WHO based standardization. Additionally, it was demonstrated that the current standardization of Quantum Blue® Adalimumab correlates very well with the WHO international standard for adalimumab.

Below you find the poster presentation by Dr. Joana Afonso:

P368 – Proactive Therapeutic Drug Monitoring is more effective than Conventional Management in Inducing Fecal Calprotectin remission in Inflammatory Bowel Disease

Fecal calprotectin is widely used as non-invasive marker in IBD diagnosis and monitoring. A team from Lisbon followed 243 patients over 2 years. For 135 patients they routinely measured infliximab trough levels and adjusted the dose (proactive TDM), while 108 patients were treated conventionally. After two years of follow-up they observed that patients in the proactive TDM arm had higher drug levels and where more likely to be in steroid-free or clinical remission. Further, they also had lower fecal calprotectin levels with concentrations below 250 µg/g. The study team concluded that proactive TDM was more effective in inducing remission and improved outcomes such as surgery and treatment discontinuation.

Shortly after the ECCO 2020 congress, the pandemic disrupted all our lives. With the pandemic still ongoing, this year’s congress had to be held fully virtual. But the pandemic has also shown how healthcare professionals are able to quickly adapt to the new situation. During the two past years, one main goal was to keep patients out of the hospital. In order to do that, gastroenterology departments turned to our fecal calprotectin home test, IBDoc® as it was the case for Edwards et al. in Birmingham, UK:

P518 – Compliance with faecal calprotectin home testing as standard during COVID-19 pandemic compared to laboratory-based testing pre-COVID

In this poster, the study team compared patients’ compliance to the fecal calprotectin test before and during the pandemic, using the ELISA lab test or the IBDoc® home test, respectively (n= 100, 50 vs 50). Compliance was recorded if a result was documented within 6 weeks of the request.

Figure 1: Compliance within the two available fecal calprotectin monitoring tests/assays

Results do not leave any doubt. The home test IBDoc® considerably increased the compliance to the calprotectin testing (70% vs 52%). Beside the increase of patients’ quality of life, home testing gives quicker results, leading to faster treatment adaptation if needed and better patient management. The team concluded that the results are illustrating the benefit of adding home testing as the standard in future care and that they will continue using the tool post-pandemic.