7 Recommendations for further research
7.1 Further research into the analytical and clinical validity of the enzyme‑linked immunosorbent assay (ELISA) kits (LISA‑TRACKER, IDKmonitor and Promonitor) is recommended, specifically on:
the best methods to measure tumour necrosis factor (TNF)‑alpha‑inhibitor levels in the presence of antibodies to TNF‑alpha inhibitors
developing primary reference standards
the accuracy for predicting clinical state
clinically meaningful thresholds.
7.2 Further research is recommended on clinical outcomes associated with using the ELISA kits (LISA‑TRACKER, IDKmonitor and Promonitor) in people whose Crohn's disease is losing response to a TNF‑alpha inhibitor. This could be through a prospective study, for local audit, or for submission to a registry. (The IBD Registry is being adapted to receive data on TNF‑alpha inhibitor levels and antibodies against TNF‑alpha inhibitors).
7.3 Further research is recommended on clinical outcomes associated with using the ELISA kits (LISA‑TRACKER, IDKmonitor and Promonitor) to monitor TNF‑alpha‑inhibitor levels and antibodies to a TNF‑alpha inhibitor in people with Crohn's disease whose disease responds to treatment with TNF‑alpha inhibitors. This should be evaluated using prospective studies.