Infliximab trough levels may predict sustained response to infliximab in patients with Crohn's disease

Bortlík, Martin; Ďuricová, Dana; Malíčková, Karin; Machková, Naděžda; Bouzkova, Eva; Hrdlička, Luděk; Komárek, Arnošt; Lukáš, Milan

doi:10.1016/j.crohns.2012.10.019

Cited by 213 publications

(159 citation statements)

References 22 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…) and also higher than those reported in other immune-mediated inflammatory diseases [35][36][37]. Consequently, it will be of interest to study whether a lower dose would achieve the same results in patients with active disease.…”

Section: Discussionmentioning

confidence: 87%

Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

et al. 2015

View full text Add to dashboard Cite

Inconclusive evidence for the efficacy of infliximab in sarcoidosis hinders the global use of this potentially beneficial drug. To study infliximab efficacy in a clinical setting, we performed a prospective open-label trial in patients refractory to conventional treatment.Patients (n=56) received eight infusions of 5 mg·kg -1 infliximab. Pulmonary function, disease activity measured by 18 F-fluorodeoxyglucose (FDG) by positron emission tomography (PET) and quality of life were part of the clinical work-up. Infliximab levels were measured before every infusion.After 26 weeks of infliximab treatment, mean improvement in forced vital capacity (FVC) was 6.6% predicted ( p=0.0007), whereas in the 6 months before start of treatment, lung function decreased. Maximum standardised uptake value (SUVmax) of pulmonary parenchyma on 18 F-FDG PET decreased by 3.93 ( p<0.0001). High SUVmax of pulmonary parenchyma at baseline predicted FVC improvement (R=0.62, p=0.0004). An overall beneficial response was seen in 79% of patients and a partial response was seen in 17% of patients. No correlation between infliximab trough level (mean 18.0 µg·mL -1 ) and initial response was found.In conclusion, infliximab causes significant improvement in FVC in refractory

show abstract

Section: Discussionmentioning

confidence: 87%

Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Trough levels of infliximab and antibodies to infliximab are increasingly used to monitor treatment and prevent loss of response. 22 However, this data was not available in this retrospective study. On the other hand, 1-year response taking into account the patients that had a recaptured response during the year was not associated with duration of CD.…”

Section: Discussionmentioning

confidence: 87%

“…Timing of removal of seton is not consensual. 31,32 Potential limitations of the study were the number of study centres (22), a long study period with a change of prescription trends and retrospective acquisition of data. In order to limit biases, we took into account the centre effect by using a clustered analysis in the Cox model, and verified that the calendar year of IFX initiation was not associated with outcome.…”

Section: Discussionmentioning

confidence: 99%

Predictors of response to infliximab in paediatric perianal Crohn's disease

Dupont-Lucas

Dabadie

Alberti

et al. 2014

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…A Czech study has shown that an infliximab (IFX) trough level of >3 μg/mL at the start of maintenance therapy was associated with sustained clinical response over a 2‐year follow‐up period 11. Similarly for adalimumab (ADL), Karmiris et al .…”

Section: Introductionmentioning

confidence: 99%

Positive relationship between infliximab and adalimumab trough levels at completion of induction therapy with clinical response rates, at a tertiary referral center

et al. 2017

View full text Add to dashboard Cite

Background and AimAnti‐tumor necrosis factor alpha (TNFα) therapies have improved outcomes for patients with inflammatory bowel disease. The aim of this study was to explore the relationship between infliximab (IFX) and adalimumab (ADL) trough and antibody levels with clinical response rates at the end of induction.MethodsThis was a prospective, single‐center study. Patients were recruited from July 2015 to August 2016. Inclusion criteria were all inflammatory bowel disease patients older than 17 years who started treatment with IFX or ADL. Baseline clinical disease activity indexes were performed. Clinical response was defined as HBI ≤3 or partial Mayo score ≤4% or <30% reduction from baseline. Anti‐TNFα trough and antibody levels were measured using standard ELISA techniques.ResultsThirty‐five patients were recruited, of whom 23 had Crohn's disease and 12 had ulcerative colitis. Eighteen were treated with ADL and 17 with IFX. The mean age of the cohort was 40.3 years, 62.9% were females, 34.3% were on concomitant thiopurines, and 25.7% had prior anti‐TNFα exposure. Overall response rate was 51.4%, 33.3% for ADL and 70.6% for IFX.Mean trough levels were 12.5 μg/mL for IFX and 4.4 μg/mL for ADL. There was a clear link between higher anti‐TNFα trough levels at the end of induction with clinical response rates. For IFX, mean trough level was 16.4 μg/mL for responders versus 5.3 μg/mL for non‐responders (P = 0.026). Area under the curve for association of IFX level at induction with clinical response was 0.864 (P = 0.0001). Similar link was present between higher ADL levels with clinical response, although not statistically significant.ConclusionHigher trough levels at the end of induction are associated with improved response. Ongoing work will define optimal targets at this key timeframe.

show abstract

Infliximab trough levels may predict sustained response to infliximab in patients with Crohn's disease

Abstract: 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.

Cited by 213 publications

References 22 publications

Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis

Predictors of response to infliximab in paediatric perianal Crohn's disease

Positive relationship between infliximab and adalimumab trough levels at completion of induction therapy with clinical response rates, at a tertiary referral center

Contact Info

Product

Resources

About