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Association of Infliximab Levels With Mucosal Healing Is Time-Dependent in Crohn’s Disease: Higher Drug Exposure Is Required Postinduction Than During Maintenance Treatment
- Source :
- Inflammatory Bowel Diseases. 25:1813-1821
- Publication Year :
- 2019
- Publisher :
- Oxford University Press (OUP), 2019.
-
Abstract
- Background Infliximab levels have been reported to be associated with mucosal healing (MH) in Crohn’s disease (CD). However, whether the association differs between postinduction (week 14) and maintenance (week 30) has seldom been investigated. We aimed to analyze the association between serum infliximab trough levels and MH at the 2 different time points. Methods A retrospective study of CD patients treated with infliximab in a tertiary referral center between January 2012 and May 2018 was conducted. MH was defined as absence of ulceration by endoscopy. Correlations between infliximab level and MH were investigated at 2 specific time points, weeks 14 and 30. Results Median infliximab levels were higher in patients with MH than those without at weeks 14 (7.5 vs 1.5 μg/mL; P < 0.001) and 30 (5.9 vs 0.5 μg/mL; P < 0.001). The median levels in patients with MH at week 14 were higher than at week 30 (7.5 vs 5.9 μg/mL; P < 0.05). Multivariate analysis showed that infliximab level was independently associated with MH (both P < 0.001 at weeks 14 and 30). Infliximab level above 4.85 μg/mL and 2.85 μg/mL identified patients with MH at week 14 (area under the curve [AUC], 0.796; P < 0.001) and week 30 (AUC, 0.780; P < 0.001) with 80% specificity. The rates of MH reached a plateau (>85%) when infliximab levels were above 10 and 6 μg/mL at weeks 14 and 30, respectively. Conclusions Infliximab levels correlated with MH at weeks 14 and 30 in CD patients. Higher levels might be required to achieve MH at postinduction than during maintenance treatment.
- Subjects :
- Adult
Male
Drug
medicine.medical_specialty
media_common.quotation_subject
Specific time
Gastroenterology
Young Adult
Crohn Disease
Gastrointestinal Agents
Internal medicine
medicine
Humans
Immunology and Allergy
In patient
Intestinal Mucosa
Retrospective Studies
media_common
Wound Healing
Crohn's disease
Tumor Necrosis Factor-alpha
business.industry
Mucous membrane
Retrospective cohort study
Middle Aged
medicine.disease
Infliximab
Logistic Models
Treatment Outcome
medicine.anatomical_structure
Area Under Curve
Mucosal healing
Multivariate Analysis
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 15364844 and 10780998
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Inflammatory Bowel Diseases
- Accession number :
- edsair.doi.dedup.....643cea84c66006663a43cfb38fb88e62