Infliximab trough levels may predict sustained response to infliximab in patients with Crohn's disease
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
23200919
DOI
10.1016/j.crohns.2012.10.019
PII: S1873-9946(12)00456-4
Knihovny.cz E-resources
- Keywords
- ATI, CD, Crohn's disease, IBD, Infliximab, Predictors, Sustained response, TL, TNF-α, anti-infliximab antibodies, inflammatory bowel disease., trough level, tumour necrosis factor alpha,
- MeSH
- Anti-Inflammatory Agents, Non-Steroidal blood therapeutic use MeSH
- C-Reactive Protein metabolism MeSH
- Time Factors MeSH
- Crohn Disease drug therapy surgery MeSH
- Adult MeSH
- Adrenal Cortex Hormones therapeutic use MeSH
- Immunosuppressive Agents therapeutic use MeSH
- Infliximab MeSH
- Drug Therapy, Combination MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Antibodies, Monoclonal blood immunology therapeutic use MeSH
- Follow-Up Studies MeSH
- Treatment Failure MeSH
- Predictive Value of Tests MeSH
- Antibodies blood MeSH
- ROC Curve MeSH
- Maintenance Chemotherapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anti-Inflammatory Agents, Non-Steroidal MeSH
- C-Reactive Protein MeSH
- Adrenal Cortex Hormones MeSH
- Immunosuppressive Agents MeSH
- Infliximab MeSH
- Antibodies, Monoclonal MeSH
- Antibodies MeSH
BACKGROUND AND AIMS: Over 10% of Crohn's disease (CD) patients annually lose response to infliximab. Infliximab trough levels (TL), concomitant immunosuppressants and endoscopic healing were proposed as predictors of favourable infliximab outcome. We assessed infliximab TL measured after induction therapy as predictors of sustained clinical response. Furthermore, we tried to identify other predictors of long-term benefit of infliximab therapy. METHODS: We included CD patients treated with infliximab between October 2007 and March 2010 who responded to 3-dose induction followed by maintenance therapy and in whom blood samples taken at treatment week 14 or 22 were available in blood bank. Sustained response to infliximab was defined as absence of treatment failure due to loss of response or drug intolerance. RESULTS: Eighty four patients were included. Sustained response to infliximab was observed in 47 (56%) patients during a median follow-up of 25 months (14-37). Infliximab TL>3μg/ml were associated with a decreased risk of treatment failure (HR 0.34; 95% CI: 0.16-0.75), whereas the presence of antibodies against infliximab and need for corticosteroids increased this risk (HR 4.34; 95% CI: 1.51-12.5 and HR 2.49, 95% CI: 1.08-5.73, respectively). No impact of concomitant thiopurines was observed, although patients receiving thiopurines had higher infliximab TL than those without immunomodulators (5.51 vs. 0.71μg/ml; p=0.01). CONCLUSION: During a median follow up of 2 years sustained response to infliximab was observed in slightly more than half of CD patients. Infliximab TL>3μg/ml at the start of maintenance regime were predicative of sustained response to infliximab.
References provided by Crossref.org
Infliximab in young paediatric IBD patients: it is all about the dosing
