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The Utility of Infliximab Therapeutic Drug Monitoring among Patients with Inflammatory Bowel Disease and Concerns for Loss of Response: A Retrospective Analysis of a Real-World Experience.
- Source :
-
Canadian journal of gastroenterology & hepatology [Can J Gastroenterol Hepatol] 2016; Vol. 2016, pp. 5203898. Date of Electronic Publication: 2016 Nov 10. - Publication Year :
- 2016
-
Abstract
- Background . Infliximab (IFX) therapeutic drug monitoring (TDM) allows for objective decision making in patients with inflammatory bowel disease (IBD) and loss of response. Questions remain about whether IFX TDM improves outcomes. Methods . Patients with IBD who had IFX TDM due to concerns for loss of response were considered for inclusion. Serum IFX trough concentration and anti-drug antibody (ADA) concentrations were measured. Patients were grouped by TDM results: group 1, low IFX/high ADA; group 2, low IFX/low ADA; group 3, therapeutic IFX. Changes in management were analyzed according to groupings; remission rates were assessed at 6 months. Results . 71 patients were included of whom 37% underwent an appropriate change in therapy. Groups 1 (67%) and 2 (83%) had high adherence compared to only 9% in group 3. At 6 months, 57% had achieved remission. More patients who underwent an appropriate change in therapy achieved remission, though this did not reach statistical significance (69% versus 49%; P = 0.098). Conclusions . A trend towards increased remission rates was associated with appropriate changes in management following TDM results. Many patients with therapeutic IFX concentrations did not undergo an appropriate change in management, potentially reflecting a lack of available out-of-class options at the time of TDM or due to uncertainty of the meaning of the reported therapeutic range.<br />Competing Interests: The authors declare that they have no competing interests.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibodies blood
Antibodies immunology
Biomarkers, Pharmacological blood
Female
Gastrointestinal Agents administration & dosage
Gastrointestinal Agents immunology
Humans
Inflammatory Bowel Diseases blood
Infliximab administration & dosage
Infliximab immunology
Male
Middle Aged
Remission Induction
Retrospective Studies
Treatment Failure
Young Adult
Drug Monitoring methods
Gastrointestinal Agents blood
Inflammatory Bowel Diseases drug therapy
Infliximab blood
Subjects
Details
- Language :
- English
- ISSN :
- 2291-2797
- Volume :
- 2016
- Database :
- MEDLINE
- Journal :
- Canadian journal of gastroenterology & hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 27957480
- Full Text :
- https://doi.org/10.1155/2016/5203898