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Infliximab in young paediatric IBD patients: it is all about the dosing
MME. Jongsma, DA. Winter, HQ. Huynh, L. Norsa, S. Hussey, KL. Kolho, J. Bronsky, A. Assa, S. Cohen, R. Lev-Tzion, S. Van Biervliet, D. Rizopoulos, TGJ. de Meij, DS. Shouval, E. Wine, VM. Wolters, C. Martinez-Vinson, L. de Ridder, Paediatric IBD...
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
NLK
ProQuest Central
od 1996-01-01 do Před 1 rokem
CINAHL Plus with Full Text (EBSCOhost)
od 2012-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 1997-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 1996-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1996-01-01 do Před 1 rokem
Family Health Database (ProQuest)
od 1996-01-01 do Před 1 rokem
Public Health Database (ProQuest)
od 1996-01-01 do Před 1 rokem
- MeSH
- dítě MeSH
- gastrointestinální látky * terapeutické užití MeSH
- idiopatické střevní záněty * farmakoterapie MeSH
- infliximab * terapeutické užití MeSH
- lidé MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients < 10 years. TDM data were collected retrospectively in 14 centres. Children treated with IFX were included if IFX was started as IBD treatment at age < 10 years (young patients, YP) and PK data were available. Older IBD patients aged 10-18 years were used as controls (older patients, OP). Two hundred and fifteen paediatric inflammatory bowel disease (PIBD) patients were eligible for the study (110 < 10 year; 105 ≥ 10 years). Median age was 8.3 years (IQR 6.9-8.9) in YP compared with 14.3 years (IQR 12.8-15.6) in OP at the start of IFX. At the start of maintenance treatment, 72% of YP had trough levels below therapeutic range (< 5.4 μg/mL). After 1 year of scheduled IFX maintenance treatment, YP required a significantly higher dose per 8 weeks compared with OP (YP; 9.0 mg/kg (IQR 5.0-12.9) vs. OP; 5.5 mg/kg (IQR 5.0-9.3); p < 0.001). The chance to develop antibodies to infliximab was relatively lower in OP than YP (0.329 (95% CI - 1.2 to - 1.01); p < 0.001), while the overall duration of response to IFX was not significantly different (after 2 years 53% (n = 29) in YP vs. 58% (n = 45) in OP; p = 0.56).Conclusion: Intensification of the induction scheme is suggested for PIBD patients aged < 10 years. What is Known? •Infliximab trough levels of paediatric IBD patients are influenced by several factors as dosing scheme, antibodies and inflammatory markers. •In 4.5-30% of the paediatric IBD patients, infliximab treatment was stopped within the first year. What is New? •The majority of young PIBD (< 10 years) have inadequate IFX trough levels at the start of maintenance treatment. •Young PIBD patients (< 10 years) were in need of a more intensive treatment regimen compared with older paediatric patients during 1 year of IFX treatment. •The chance to develop antibodies to infliximab was relatively higher in young PIBD patients (< 10 years).
Department of Biostatistics Erasmus Medical Center Rotterdam The Netherlands
Department of Paediatric Gastroenterology Hôpital Robert Debré Paris France
Department of Paediatric Gastroenterology Our Lady's Children's Hospital and RCSI Dublin Ireland
Department of Paediatric Gastroenterology Shaare Zedek Medical Center Jerusalem Israel
Department of Paediatric Gastroenterology Universitair Ziekenhuis Ghent Belgium
Citace poskytuje Crossref.org
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- $a Jongsma, Maria M E $u Department of Paediatric Gastroenterology, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands
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- $a Infliximab in young paediatric IBD patients: it is all about the dosing / $c MME. Jongsma, DA. Winter, HQ. Huynh, L. Norsa, S. Hussey, KL. Kolho, J. Bronsky, A. Assa, S. Cohen, R. Lev-Tzion, S. Van Biervliet, D. Rizopoulos, TGJ. de Meij, DS. Shouval, E. Wine, VM. Wolters, C. Martinez-Vinson, L. de Ridder, Paediatric IBD Porto Group of ESPGHAN
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- $a Infliximab (IFX) is administered intravenously using weight-based dosing (5 mg/kg) in inflammatory bowel disease (IBD) patients. Our hypothesis is that especially young children need a more intensive treatment regimen than the current weight-based dose administration. We aimed to assess IFX pharmacokinetics (PK), based on existing therapeutic drug monitoring (TDM) data in IBD patients < 10 years. TDM data were collected retrospectively in 14 centres. Children treated with IFX were included if IFX was started as IBD treatment at age < 10 years (young patients, YP) and PK data were available. Older IBD patients aged 10-18 years were used as controls (older patients, OP). Two hundred and fifteen paediatric inflammatory bowel disease (PIBD) patients were eligible for the study (110 < 10 year; 105 ≥ 10 years). Median age was 8.3 years (IQR 6.9-8.9) in YP compared with 14.3 years (IQR 12.8-15.6) in OP at the start of IFX. At the start of maintenance treatment, 72% of YP had trough levels below therapeutic range (< 5.4 μg/mL). After 1 year of scheduled IFX maintenance treatment, YP required a significantly higher dose per 8 weeks compared with OP (YP; 9.0 mg/kg (IQR 5.0-12.9) vs. OP; 5.5 mg/kg (IQR 5.0-9.3); p < 0.001). The chance to develop antibodies to infliximab was relatively lower in OP than YP (0.329 (95% CI - 1.2 to - 1.01); p < 0.001), while the overall duration of response to IFX was not significantly different (after 2 years 53% (n = 29) in YP vs. 58% (n = 45) in OP; p = 0.56).Conclusion: Intensification of the induction scheme is suggested for PIBD patients aged < 10 years. What is Known? •Infliximab trough levels of paediatric IBD patients are influenced by several factors as dosing scheme, antibodies and inflammatory markers. •In 4.5-30% of the paediatric IBD patients, infliximab treatment was stopped within the first year. What is New? •The majority of young PIBD (< 10 years) have inadequate IFX trough levels at the start of maintenance treatment. •Young PIBD patients (< 10 years) were in need of a more intensive treatment regimen compared with older paediatric patients during 1 year of IFX treatment. •The chance to develop antibodies to infliximab was relatively higher in young PIBD patients (< 10 years).
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- $a Winter, Dwight A $u Department of Paediatric Gastroenterology, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands
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- $a Huynh, Hien Q $u Division of Paediatric Gastroenterology and Nutrition, Edmonton Paediatric IBD Clinic (EPIC), University of Alberta, Edmonton, Canada
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- $a Bronsky, Jiri $u Department of Paediatrics, Gastroenterology and Nutrition Unit, University Hospital Motol, Prague, Czech Republic
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- $a Wine, Eytan $u Division of Paediatric Gastroenterology and Nutrition, Edmonton Paediatric IBD Clinic (EPIC), University of Alberta, Edmonton, Canada
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