Letter: persistence of anti‐infliximab antibodies after discontinuation of infliximab in patients with <scp>IBD</scp>

Steenholdt, Casper; Brynskov, J.; Bendtzen, Klaus

doi:10.1111/j.1365-2036.2012.05204.x

Cited by 9 publications

(6 citation statements)

References 8 publications

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“…Low‐titre anti‐drug antibodies can often be overcome with dose intensification, and do not appear to reduce the likelihood of response as compared to patients with undetectable anti‐drug antibodies . Differences in assay methodology result in varying sensitivity to detect various anti‐drug antibody subtypes, and adjusting for these differences is difficult due to a wide variation in the relative proportions of anti‐drug antibody subtypes between individuals . Therefore, ATI and ATA cut‐offs are assay specific.…”

Section: Resultsmentioning

confidence: 99%

“…Initially, high titres of ATI do not consistently predict for antibody persistence . Although ATA tend to occur at lower rates, they appear to have a higher rate of persistence and, in turn, greater chance of loss‐of‐response compared with ATI . Once ATI or ATA are detected, repeat testing at a later time point to differentiate transient from persistent antibodies is recommended where appropriate.…”

Section: Resultsmentioning

confidence: 99%

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Review article: consensus statements on therapeutic drug monitoring of anti‐tumour necrosis factor therapy in inflammatory bowel diseases

Mitrev¹,

Casteele

Seow³

et al. 2017

Aliment Pharmacol Ther

245

207

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Summary Background Therapeutic drug monitoring (TDM) in inflammatory bowel disease (IBD) patients receiving anti‐tumour necrosis factor (TNF) agents can help optimise outcomes. Consensus statements based on current evidence will help the development of treatment guidelines. Aim To develop evidence‐based consensus statements for TDM‐guided anti‐TNF therapy in IBD. Methods A committee of 25 Australian and international experts was assembled. The initial draft statements were produced following a systematic literature search. A modified Delphi technique was used with 3 iterations. Statements were modified according to anonymous voting and feedback at each iteration. Statements with 80% agreement without or with minor reservation were accepted. Results 22/24 statements met criteria for consensus. For anti‐TNF agents, TDM should be performed upon treatment failure, following successful induction, when contemplating a drug holiday and periodically in clinical remission only when results would change management. To achieve clinical remission in luminal IBD, infliximab and adalimumab trough concentrations in the range of 3‐8 and 5‐12 μg/mL, respectively, were deemed appropriate. The range may differ for different disease phenotypes or treatment endpoints—such as fistulising disease or to achieve mucosal healing. In treatment failure, TDM may identify mechanisms to guide subsequent decision‐making. In stable clinical response, TDM‐guided dosing may avoid future relapse. Data indicate drug‐tolerant anti‐drug antibody assays do not offer an advantage over drug‐sensitive assays. Further data are required prior to recommending TDM for non‐anti‐TNF biological agents. Conclusion Consensus statements support the role of TDM in optimising anti‐TNF agents to treat IBD, especially in situations of treatment failure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Review article: consensus statements on therapeutic drug monitoring of anti‐tumour necrosis factor therapy in inflammatory bowel diseases

Mitrev¹,

Casteele

Seow³

et al. 2017

Aliment Pharmacol Ther

245

207

View full text Add to dashboard Cite

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“…Moreover, antibody concentrations determined were similar in all cases, and an excellent correlation was found between the assays. It has been described that ATI can persist in the blood years after IFX is discontinued 13. In the case of loss of response many patients can be switched to ADL, which can also induce an immune response.…”

Section: Discussionmentioning

confidence: 99%

Antibodies to infliximab in Remicade-treated rheumatic patients show identical reactivity towards biosimilars

et al. 2016

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Anti-IFX antibodies of Remicade-treated patients cross-react with either Inflectra or Remsima. Although additional epitopes may be present in the biosimilar, results suggest that epitopes influencing the immune response to IFX are also present in the biosimilar. Antibody-positive patients treated with Remicade should not be switched to the biosimilar, since antibodies will interact with the new drug and potentially lead to loss of response. This finding supports the utility for therapeutic drug monitoring before a switching strategy is considered.

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“…13,21 Persistent ATI in subject’s even years after infliximab discontinuation has also been reported. 31,32 …”

Section: Discussionmentioning

confidence: 99%

Antibodies to Infliximab Are Associated with Lower Infliximab Levels and Increased Likelihood of Surgery in Pediatric IBD

Zitomersky

Atkinson

Fournier

et al. 2015

Inflammatory Bowel Diseases

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Background Adult studies suggest antibodies to infliximab (ATI) correlate with loss of response in inflammatory bowel disease but pediatric data are limited. Methods We conducted a cross-sectional study of trough infliximab levels and ATI in 134 pediatric and young adult patients receiving infliximab. At the time serum was obtained demographics, disease phenotype, duration of infliximab therapy, use of combination therapy (methotrexate or 6-mercaptopurine with infliximab), and surgery were recorded. Results Assays were performed on 134 subjects currently receiving infliximab (85 male; mean age, 17.3 ± 4.3 years; 114 Crohn’s disease and 20 ulcerative colitis). Infliximab use ranged from 12 days to 12 years: median 2.0 (interquartile range [1.1–4.3]) years. Twenty-seven of 134 (20%) patients had ATI ≥5 U/mL. Of patients with ATI ≥5 U/mL, 59% had infliximab levels <5 μg/mL, compared with 14% of patients with ATI <5 U/mL (P < 0.001). Ten (7%) patients (9 Crohn’s disease, 1 ulcerative colitis) underwent bowel resections after beginning infliximab infusions. Sixty percent who underwent surgery had ATI ≥12 U/mL; in contrast, only 8% of patients who did not undergo surgery had ATI ≥12 U/mL (P = 0.01). At the time of serum sampling, 50 (37%) patients were receiving combination therapy, compared with 84 (63%) on infliximab alone. Combination therapy at the time of serum sampling did not correlate with either increase infliximab levels or lower ATI compared with infliximab monotherapy. However, prior immunomodulator use was associated with lower antibody levels (P = 0.007). Conclusions ATI correlates with reduction in infliximab level and a higher risk of surgery in patients with inflammatory bowel disease.

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Letter: persistence of anti‐infliximab antibodies after discontinuation of infliximab in patients with IBD

Cited by 9 publications

References 8 publications

Review article: consensus statements on therapeutic drug monitoring of anti‐tumour necrosis factor therapy in inflammatory bowel diseases

Review article: consensus statements on therapeutic drug monitoring of anti‐tumour necrosis factor therapy in inflammatory bowel diseases

Antibodies to infliximab in Remicade-treated rheumatic patients show identical reactivity towards biosimilars

Antibodies to Infliximab Are Associated with Lower Infliximab Levels and Increased Likelihood of Surgery in Pediatric IBD

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