Association of novel serum biomarkers (Oncostatin M, 90K/Mac-2 BP, and IL-12 p40) with adalimumab target trough level achievement and response in Iraqi inflammatory bowel disease patients: A cross-sectional real-world study

Fecal calprotectin, fecal lactoferrin, and C-reactive protein are well-established biomarkers of inflammatory bowel disease (IBD) activity. This study explores novel serum biomarkers, including Oncostatin M (OSM), 90K/Mac-2 binding protein (90K), and interleukin (IL)-12 p40, and their possible association with the achievement of target adalimumab (ADL) trough level (TL) and with clinical response among 88 Iraqi adult patients with IBD. In this cohort, serum OSM was significantly higher in patients who failed to achieve the target adalimumab TL (median 198.61 pg/ml, IQR 139.57–276.86) compared to those who did (median 134.61 pg/ml, IQR 108.47–192.71; p = 0.004). In multivariate logistic regression, each 1 pg/ml increase in OSM raised the odds of not achieving the target TL (OR 1.007; 95% CI 1.002–1.013; p = 0.006). Notably, OSM did not differentiate patients in clinical remission from those with active disease ( p > 0.05). Similarly, serum 90K and IL-12 p40 showed no significant differences between patient groups stratified by TL achievement or disease activity. In conclusion, serum OSM levels were significantly higher in patients failing to achieve adalimumab target trough levels and were significantly associated with adalimumab TL achievement in this Iraqi cohort, demonstrating the feasibility of serum OSM measurement in a real-world clinical setting.